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.
KeywordsArthritis Osteoporosis Osteoarthritis Tray Versed
- 8.Kim KI, Ramteke AA, Bae DK. Navigation-assisted minimal invasive total knee arthroplasty in patients with extra-articular femoral deformity. J Arthroplasty. 2009;25:658.e17–22.Google Scholar
- 13.Madan S, Ranjith RK, Fiddian NJ. Total knee replacement following high tibial osteotomy. Bull Hosp Jt Dis. 2002–2003;61:5–10.Google Scholar
- 15.Mullaji A, Kanna R, Marawar S, Kohli A, Sharma A. Comparison of limb and component alignment using computer-assisted navigation versus image intensifier-guided conventional total knee arthroplasty: a prospective, randomized, single-surgeon study of 467 knees. J Arthroplasty. 2007;22:953–9.PubMedCrossRefGoogle Scholar
- 17.Mullaji AB, Shetty GM. Correction of varus deformity during TKA with reduction osteotomy. Clin Orthop Relat Res. 2014;472:126–32.Google Scholar
- 18.Mason JB, Fehring TK. Management of extra-articular deformity in total knee arthroplasty with navigation. In: Scott WN, editor. Insall & scott surgery of the knee. Philadelphia: Elsevier Churchill Livingstone; 2012. p. 1234.Google Scholar