Advertisement

Varus Knee

  • Leo A. Whiteside
Chapter

Abstract

Medial stability of the knee is a complex issue, and involves ligaments that behave differently in flexion and extension. The contracture and stretching that occur due to deformity and osteophytes affect these ligament structures unequally, and often cause different degrees of tightness or laxity in flexion and extension after the bone surfaces are resected correctly for varus-valgus alignment. The distortion of the joint surface also can cause varus-valgus alignment to differ in the flexed and extended positions, and the knee thus may require adjustment of portions of the medial stabilizing complex that affect stability either in flexion or extension.

Keywords

Total Knee Arthroplasty Posterior Cruciate Ligament Medial Collateral Ligament Lateral Collateral Ligament Posterior Capsule 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Anouchi YS, Whiteside LA, Kaiser AD, Milliano MT: The effect of axial rotational alignment of the femoral component on knee stability and patellar tracking in total knee arthroplasty. Clin Orthop 287:170–177, 1991.Google Scholar
  2. 2.
    Arima J, Whiteside LA: Femoral rotational alignment, based on the anterior-posterior axis, in total knee arthroplasty in a valgus knee. J Bone Joint Surg 77A: 1331–1334, 1995.Google Scholar
  3. 3.
    Burks RT: Gross Anatomy. In Daniel D, Akeson W, O’Connor J (eds). Knee Ligaments: Structure, Function, Injury, and Repair. New York, Raven Press 59–76, 1990.Google Scholar
  4. 4.
    Grood ES, Noyes FR, Butler DJ, Suntay WJ: Ligamentous and capsular restraints preventing straight medial and lateral laxity in intact human cadaver knees. J Bone Joint Surg 63A:1257–1269, 1981.Google Scholar
  5. 5.
    Grood ES, Stowers SF, Noyes FR: Limits of movement in the human knee. J Bone Joint Surg 70A:88–97, 1988.Google Scholar
  6. 6.
    Hull ML, Berns GS, Varma H, Patterson HA: Strain in the medial collateral ligament of the human knee under single and combined loads. J Biomech 29:199–206, 1996.PubMedCrossRefGoogle Scholar
  7. 7.
    Insall JN, Ranawat CS, Scott WN, Walker PS: Total condylar knee replacement. Clin Orthop 120:149–154, 1976.PubMedGoogle Scholar
  8. 8.
    Martin JW, Whiteside LA: The influence of joint line position on knee stability after condylar knee arthroplasty. Clin Orthop 259:146–156, 1990.PubMedGoogle Scholar
  9. 9.
    Matsuda S, Matsuda H, Miyagi T, Sasaki K, Iwamoto Y, Miura H: Femoral condyle geometry in the normal and varus knee. Clin Orthop 349:183–188, 1998.PubMedCrossRefGoogle Scholar
  10. 10.
    Nielson S, Ovesen J, Rasmussen O: The posterior cruciate ligament and rotatory knee instability. An experimental study. Arch Orthop Trauma Surg 104:53–56, 1985.CrossRefGoogle Scholar
  11. 11.
    Warren LF, Marshall JL: The supporting structures and layers on the medial side of the knee. J Bone Joint Surg 61A:56–62, 1979.Google Scholar
  12. 12.
    Warren LF, Marshall JL, Girgis F: The prime static stabilizer of the medial side of the knee. J Bone Joint Surg 56A:665–674, 1974.Google Scholar
  13. 13.
    Whiteside LA : Intramedullary alignment of total knee replacement. A clinical and laboratory study. Orthop Review (suppl) 9–12, 1989Google Scholar
  14. 14.
    Whiteside LA: Correction of ligament and bone defects in total arthroplasty of the severely valgus knee. Clin Orthop 288:234–245, 1993.PubMedGoogle Scholar
  15. 15.
    Whiteside LA: Ligament release and bone grafting in total arthroplasty of the varus knee. Orthopedics 18:117–122, 1995.Google Scholar
  16. 16.
    Whiteside LA, Arima J: The anterior-posterior axis for femoral rotational alignment in valgus total knee arthroplasty. Clin Orthop 321:168–172, 1995.PubMedGoogle Scholar
  17. 17.
    Whiteside LA, Kasselt MR, Haynes DW: Varus and valgus and rotational stability in rotationally unconstrained total knee arthroplasty. Clin Orthop 219:147–157, 1987.PubMedGoogle Scholar
  18. 18.
    Whiteside LA, McCarthy DS: Laboratory evaluation of alignment and kinematics in a unicompartmental knee arthroplasty inserted with intramedullary instrumentation. Clin Orthop 274:238–247, 1992.PubMedGoogle Scholar
  19. 19.
    Whiteside LA, Saeki K, Mihalko MW: Functional medial ligament balancing in total knee arthroplasty. Clin Orthop 380:45–57, 2000.PubMedCrossRefGoogle Scholar
  20. 20.
    Whiteside LA, Summers RG: Anatomical landmarks for an intramedullary alignment system for total knee replacement. Orthop Trans 7:546–547, 1983.Google Scholar
  21. 21.
    Whiteside LA, Summers RG: The Effect of the Level of Distal Femoral Resection on Ligament Balance in Total Knee Replacement. In Dorr LD (ed). The Knee: Papers of the First Scientific Meeting of the Knee Society. Baltimore, University Park Press 59–73, 1984.Google Scholar
  22. 22.
    Yoshii I, Whiteside LA, White SE, Milliano MT: Influence of prosthetic joint line position on knee kinematics and patellar position. J Arthroplasty 6:169–177, 1991.PubMedCrossRefGoogle Scholar
  23. 23.
    Yoshioka Y, Siu D, Cooke TDV: The anatomy and functional axes of the femur. J Bone Joint Surg 69A:873–880, 1987.Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg New York 2004

Authors and Affiliations

  • Leo A. Whiteside
    • 1
  1. 1.Biomechanical Research LaboratoryMissouri Bone and Joint CenterSt. LouisUSA

Personalised recommendations