Extra-articular deformities in arthritic knees-a grueling challenge for arthroplasty surgeons: An evidence-based update
Critical to the success of a total knee arthroplasty (TKA) is the anatomical alignment. This may appear as a challenge in an extra-articular deformity (EAD) that may be inherent in certain people or result from fracture malunion, congenital disorders, nutritional, metabolic and infective causes. Thi...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Open Medical Publishing
2018-02-01
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| Series: | Orthopedic Reviews |
| Subjects: | |
| Online Access: | http://www.pagepress.org/journals/index.php/or/article/view/7374 |
| _version_ | 1818938508924944384 |
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| author | Vishesh Khanna Senthil N. Sambandam Munis Ashraf Varatharaj Mounasamy |
| author_facet | Vishesh Khanna Senthil N. Sambandam Munis Ashraf Varatharaj Mounasamy |
| author_sort | Vishesh Khanna |
| collection | DOAJ |
| description | Critical to the success of a total knee arthroplasty (TKA) is the anatomical alignment. This may appear as a challenge in an extra-articular deformity (EAD) that may be inherent in certain people or result from fracture malunion, congenital disorders, nutritional, metabolic and infective causes. This appraisal aimed at providing the reader with an up-todate overview of the research carried out on, and existent evidence of EAD correction while planning a TKA. We reviewed the current English literature on TKA in extra-articular knee deformities. Among the published data, a common initial approach of mandatory clinical and radiological assessment emerges as an obligatory step while handling cases with EAD. While several methods of managing the deformity and arthritis have been described, a broad division into intra-articular and extra-articular means can be deciphered. The relatively old-school, yet reliable thought process of extra-articular correction allows an all-inclusive restoration of alignment with the inherent complications related to the necessary osteotomy. A cohort of younger and more venturesome surgeons seem inclined towards performing navigated, intra-articular correction for mild to moderate and sometimes, severe deformities. The crux of the matter lies is obtaining a well-balanced knee without violating the all-important cruciates. Restoring the patient’s ambulatory status seems sooner with the intra-articular methods which are also more precise in determining the axes and while removing minimum bone. Greatest satisfaction is accomplished in those with less grotesque, rotationallyaligned knees while meticulously balancing soft-tissues and encouraging earlier weightbearing. |
| first_indexed | 2024-12-20T06:08:59Z |
| format | Article |
| id | doaj.art-835ed82a229b40419c54dec133cf0fc7 |
| institution | Directory Open Access Journal |
| issn | 2035-8237 2035-8164 |
| language | English |
| last_indexed | 2024-12-20T06:08:59Z |
| publishDate | 2018-02-01 |
| publisher | Open Medical Publishing |
| record_format | Article |
| series | Orthopedic Reviews |
| spelling | doaj.art-835ed82a229b40419c54dec133cf0fc72022-12-21T19:50:45ZengOpen Medical PublishingOrthopedic Reviews2035-82372035-81642018-02-019410.4081/or.2017.73743884Extra-articular deformities in arthritic knees-a grueling challenge for arthroplasty surgeons: An evidence-based updateVishesh Khanna0Senthil N. Sambandam1Munis Ashraf2Varatharaj Mounasamy3Sunshine Hospitals, Secunderabad, TelanganLouis A Johnson VA Medical Center, Clarksburg, WV, USAK.G. Hospital and Post Graduate Medical Institute, Arts College Road, Coimbatore, Tamil NaduVCU Medical Center Ambulatory Care Center, Richmond, VACritical to the success of a total knee arthroplasty (TKA) is the anatomical alignment. This may appear as a challenge in an extra-articular deformity (EAD) that may be inherent in certain people or result from fracture malunion, congenital disorders, nutritional, metabolic and infective causes. This appraisal aimed at providing the reader with an up-todate overview of the research carried out on, and existent evidence of EAD correction while planning a TKA. We reviewed the current English literature on TKA in extra-articular knee deformities. Among the published data, a common initial approach of mandatory clinical and radiological assessment emerges as an obligatory step while handling cases with EAD. While several methods of managing the deformity and arthritis have been described, a broad division into intra-articular and extra-articular means can be deciphered. The relatively old-school, yet reliable thought process of extra-articular correction allows an all-inclusive restoration of alignment with the inherent complications related to the necessary osteotomy. A cohort of younger and more venturesome surgeons seem inclined towards performing navigated, intra-articular correction for mild to moderate and sometimes, severe deformities. The crux of the matter lies is obtaining a well-balanced knee without violating the all-important cruciates. Restoring the patient’s ambulatory status seems sooner with the intra-articular methods which are also more precise in determining the axes and while removing minimum bone. Greatest satisfaction is accomplished in those with less grotesque, rotationallyaligned knees while meticulously balancing soft-tissues and encouraging earlier weightbearing.http://www.pagepress.org/journals/index.php/or/article/view/7374complex total knee replacement, extra-articular deformities, intra-articular versus extra-articular correction, navigated total knee arthroplasty |
| spellingShingle | Vishesh Khanna Senthil N. Sambandam Munis Ashraf Varatharaj Mounasamy Extra-articular deformities in arthritic knees-a grueling challenge for arthroplasty surgeons: An evidence-based update Orthopedic Reviews complex total knee replacement, extra-articular deformities, intra-articular versus extra-articular correction, navigated total knee arthroplasty |
| title | Extra-articular deformities in arthritic knees-a grueling challenge for arthroplasty surgeons: An evidence-based update |
| title_full | Extra-articular deformities in arthritic knees-a grueling challenge for arthroplasty surgeons: An evidence-based update |
| title_fullStr | Extra-articular deformities in arthritic knees-a grueling challenge for arthroplasty surgeons: An evidence-based update |
| title_full_unstemmed | Extra-articular deformities in arthritic knees-a grueling challenge for arthroplasty surgeons: An evidence-based update |
| title_short | Extra-articular deformities in arthritic knees-a grueling challenge for arthroplasty surgeons: An evidence-based update |
| title_sort | extra articular deformities in arthritic knees a grueling challenge for arthroplasty surgeons an evidence based update |
| topic | complex total knee replacement, extra-articular deformities, intra-articular versus extra-articular correction, navigated total knee arthroplasty |
| url | http://www.pagepress.org/journals/index.php/or/article/view/7374 |
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