Total knee arthroplasty in patients with excessive external

J Arthroplasty · Apr 2013

Total knee arthroplasty in patients with excessive external tibial torsion >45° and patella instability--surgical technique and follow up.

Patients presenting with advanced knee osteoarthritis (OA), excessive external tibial torsion (EETT) and chronic patella subluxation pose significant surgical challenges. A combination of TKA, tibial derotation osteotomy, and tibial tuberosity transfer was performed in ten patients (twelve knees) with OA secondary to EETT and patellar instability. ⋯ The mean pre-operative external tibial torsion was 62°, with an average rotational correction of 30°. Significant improvement was found in the Knee Society Score, SF-12 and all WOMAC questionnaire score subscales (p<0.0001); 5 patients had complications, but no loosening or nonunion was seen.

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- Michael Drexler, Tim Dwyer, Meir Marmor, Nikolaus Reischl, Fahad Attar, and John Cameron.
- Holland Orthopaedic and Arthritic Centre, Sunnybrook Health Sciences Centre, 43 Wellesley Street East. Toronto, ON, Canada.
- J Arthroplasty. 2013 Apr 1; 28 (4): 614-9.
AbstractPatients presenting with advanced knee osteoarthritis (OA), excessive external tibial torsion (EETT) and chronic patella subluxation pose significant surgical challenges. A combination of TKA, tibial derotation osteotomy, and tibial tuberosity transfer was performed in ten patients (twelve knees) with OA secondary to EETT and patellar instability. Six weeks of non weight-bearing and flexion limited to 45° was mandated after surgery. The mean follow-up and patient age was 81months (range, 14 to 159) and 56years (range, 49 to 62). The mean pre-operative external tibial torsion was 62°, with an average rotational correction of 30°. Significant improvement was found in the Knee Society Score, SF-12 and all WOMAC questionnaire score subscales (p<0.0001); 5 patients had complications, but no loosening or nonunion was seen.Copyright © 2013 Elsevier Inc. All rights reserved.

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Total knee arthroplasty in patients with excessive external tibial torsion >45° and patella instability--surgical technique and follow up.

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