Protesizzazione del ginocchio con accesso laterale e distacco della TTA nelle deformità in valgo e nelle displasie della femoro-rotulea: indicazioni, tecnica, risultati, complicanze
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Knee arthroplasty with lateral capsular access and elevation of the tibial tubercle in severe valgus deformities: indications, technique, results and complications
The valgus osteoarthritic knee is challenging technically and numerous methods for creating symmetric flexion and extension gaps during knee arthroplasty have been proposed and no consensus exists about the optimal technique.
The medial approach has many disadvantages that include patellar problems and so we adopted a lateral capsular access, with elevation of the tibial tubercle, in 43 knees that have been excellent/good knee scores in 89% with 29 cruciate-retaining TKAs
Surgical technique is direct, the lateral release is performed as part of the approach, patello-femoral tracking is optimized, medial blood preserved and fixed external tibial rotation deformities spontaneous correction is an additional benefit.
I suggest this technique in: valgus knees> 10°–12° on the mechanical axis or with fixed external tibial rotation deformities or patellar-femoral major disorders or previous longitudinal lateral scars.
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