Clin Orthop Surg.  2013 Dec;5(4):287-291. 10.4055/cios.2013.5.4.287.

Comparison of Complete Distal Release of the Medial Collateral Ligament and Medial Epicondylar Osteotomy during Ligament Balancing in Varus Knee Total Knee Arthroplasty

• Sim JA
• Lee YS
• Kwak JH
• Yang SH
• Kim KH
• Lee BK

• KMID: 1787031
• DOI: http://doi.org/10.4055/cios.2013.5.4.287

Abstract

BACKGROUND
During ligament balancing for severe medial contracture in varus knee total knee arthroplasty (TKA), complete distal release of the medial collateral ligament (MCL) or a medial epicondylar osteotomy can be necessary if a large amount of correction is needed.
METHODS
This study retrospectively reviewed 9 cases of complete distal release of the MCL and 11 cases of medial epicondylar osteotomy which were used to correct severe medial contracture. The mean follow-up periods were 46.5 months (range, 36 to 78 months) and 39.8 months (range, 32 to 65 months), respectively.
RESULTS
There were no significant differences in the clinical results between the two groups. However, the valgus stress radiograph revealed significant differences in medial instability. In complete distal release of the MCL, some stability was obtained by repair and bracing but the medial instability could not be removed completely.
CONCLUSIONS
Medial epicondylar osteotomy for a varus deformity in TKA could provide constant medial stability and be a useful ligament balancing technique.

Keyword

Varus knee; Total knee arthroplasty; Medial epicondylar osteotomy

MeSH Terms

Aged
Aged, 80 and over
Arthroplasty, Replacement, Knee/*methods
Female
Humans
Knee Joint/physiopathology/radiography/*surgery
Ligaments
Ligaments, Articular/*physiopathology
Medial Collateral Ligament, Knee/physiopathology/*surgery
Middle Aged
Osteotomy/*methods
Retrospective Studies
Treatment Outcome

Figure

• 

  Fig. 1 The valgus stress radiograph shows 3 degrees of difference from the contralateral side in group 1.

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  Fig. 2 The valgus stress radiograph shows no side-to-side difference in group 2.

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  Fig. 3 Difference in the valgus angles between groups 1 and 2 at postoperative three months and at the final follow-up.

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