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Deformity correction with total knee arthroplasty for severe knee osteoarthritis accompanying extra-articular femoral deformity: the results are promising

  • Knee
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study aimed to evaluate patients with severe degenerative osteoarthritis of the knee and extra-articular femoral deformities treated with total knee arthroplasty (TKA) and acute deformity correction.

Methods

Ten patients with severe degenerative osteoarthritis of the knee and extra-articular femoral deformities were included, and the median age was 63 years (range 38–67). The etiology was post-traumatic malunion in four patients, rickets sequelae in four patients, and surgical sequelae due to multiple epiphyseal dysplasia in two patients. The severity of degenerative osteoarthritis and deformity analyses were assessed according to the Kellgren–Lawrence and Paley criteria, respectively. The median number of previous operations the patients had undergone was two (range 0–3), and the median Oxford Knee Society score was 9 (range 5–13) before treatment. All patients were treated with primary TKA and deformity correction in the same surgery. The TKA was completed first, followed by an osteotomy at the apex of the deformity. Finally, a retrograde intramedullary nail was inserted.

Results

The median follow-up period was 44 (31–60) months. A stable and functional knee joint, a physiological mechanical axis, and solid osseous union were achieved in all patients. Late prosthetic failure was seen in one patient due to deep infection. The median Oxford Knee Society score was 42 (range 37–47) at the final follow-up.

Conclusions

Combining several procedures in single setting for the treatment of severe knee osteoarthritis accompanied by extra-articular deformity may eliminate the need for multiple surgeries. Furthermore, a proper physiological mechanical axis can be obtained without causing substantial bone loss.

Level of evidence

IV.

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Acknowledgements

We thank Peter Mittwede, MD, Ph.D., from Edanz Group (http://www.edanzediting.com/ac) for editing a draft of this manuscript.

Funding

No external funds were received in support of this work. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery and Traumatology, Metin Sabanci Baltalimani Kemik Hastaliklari Egitim ve Arastirma Hastanesi Ortopedi ve Travmatoloji Klinigi, Rumeli Hisari Cad. No: 62, Baltalimani, Sariyer, 34470, Istanbul, Turkey

    B. Demir, B. Özkul, M. S. Saygılı, E. Çetinkaya & D. Akbulut

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  1. B. Demir
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  2. B. Özkul
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  3. M. S. Saygılı
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  4. E. Çetinkaya
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Corresponding author

Correspondence to B. Özkul.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

Institutional review board (IRB)/Ethics committee approval was obtained (ID number 15) on 9/20/2017 from the Metin Sabanci Baltalimani Bone Diseases Training and Research Hospital (Istanbul, Turkey).

Informed consent

Patients were informed, and they consented to conduct the study.

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Demir, B., Özkul, B., Saygılı, M.S. et al. Deformity correction with total knee arthroplasty for severe knee osteoarthritis accompanying extra-articular femoral deformity: the results are promising. Knee Surg Sports Traumatol Arthrosc 26, 3444–3451 (2018). https://doi.org/10.1007/s00167-018-4920-8

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  • DOI: https://doi.org/10.1007/s00167-018-4920-8

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