In most total knee arthroplasties (TKAs) for arthritic knees with intra-articular varus or valgus deformity, both alignment and ligament balance can be achieved with appropriate bone cuts and soft-tissue releases. However, TKA becomes technically challenging when knee arthritis is associated with an extra-articular deformity (EAD) of either the femur or the tibia. Such deformities are commonly caused secondary to trauma (malunion or non-union), previous osteotomy, metabolic causes such as osteomalacia or osteoporosis causing excessive bowing or stress fractures and congenital causes (Fig. 8.1). Stress fracture although uncommon is a frequent cause of tibial EAD in patients with knee arthritis.
KeywordsProximal Tibia Tibial Component High Tibial Osteotomy Mechanical Axis Corrective Osteotomy
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