Abstract：
BACKGROUND:Postoperative varus alignment has been associated with lower IKS scores and increased failure rates. Appropriate positioning of TKA components therefore is a key concern of surgeons. However, obtaining neutral alignment can be challenging in patients with substantial preoperative varus deformity and it is unclear whether residual deformity influences revision rates. QUESTIONS/PURPOSES:We asked: (1) in patients with preoperative varus deformities, does residual postoperative varus limb alignment lead to increased revision rates or lower IKS scores compared with correction to neutral alignment, (2) does placing the tibial component in varus alignment lead to increased revision rates and lower IKS scores, (3) does femoral component alignment affect revision rates and IKS scores, and (4) do these findings change in patients with at least 10° varus alignment preoperatively? PATIENTS AND METHODS:From a prospective database, we identified 553 patients undergoing TKAs for varus osteoarthritis. Patients were divided into those with residual postoperative varus and those with neutral postoperative alignment. Revision rates and International Knee Society (IKS) scores were compared between the two groups and assessed based on postoperative component alignment. Survival analysis was conducted with revision as the endpoint. The analysis was repeated in a subgroup of patients with at least 10° preoperative varus. Minimum followup was 2 years (median, 4.7 years; range, 2-19.8 years). RESULTS:The two groups had similar survival rates to 10 years and similar IKS scores. Varus tibial component alignment and valgus femoral component alignment were associated with lower mean scores. Revision rates and scores were similar in a subgroup of patients with substantial preoperative varus. CONCLUSIONS:Our data suggest residual postoperative varus deformity after TKA does not increase survival rates at medium-term in patients with preoperative varus deformities, providing tibial component varus is avoided. Tibial component varus negatively influences IKS score. LEVEL OF EVIDENCE:Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Magnussen RA,Weppe F,Demey G,Servien E,Lustig Sdoi
10.1007/s11999-011-1988-6subject
Has Abstractpub_date
2011-12-01 00:00:00pages
3443-50issue
12eissn
0009-921Xissn
1528-1132journal_volume
469pub_type
杂志文章abstract：:A test for knee posterolateral instability, which is a modification of the standard posterolateral rotatory instability test, is described. In this test, the patient lies supine on the examination table with hips and knees flexed to 90 degrees. The examiner grasps both feet and attempts to maximally externally rotate ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1991-03-01 00:00:00
abstract：:The factors which determine the rate and amount of acetabular growth in congenital dislocation of the hip are ill-understood. A prospective radiological study has been devised in order to assess the influence of the age of congruity, femoral anteversion and neck/shaft angles on acetabular growth. To be included, the c...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1976-09-01 00:00:00
abstract：:Spinal cord injury (SCI) results in multiple degenerative changes that may in part be related to physical inactivity. There are indications that some of these changes may be reversed by exercise and fitness training. Computerized functional electrical stimulation (FES) allows active exercise of limbs paralyzed by uppe...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-08-01 00:00:00
abstract：:Therapeutic radiation delivered to bone and the adjacent local tissues before allograft limb-salvage surgery has been associated with poor graft incorporation and higher numbers of clinical complications. Our objective was to determine the effect of preoperative radiation therapy on specific histologic, molecular and ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000165732.64757.bb
更新日期：2005-06-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-010-1291-y
更新日期：2010-08-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-10-01 00:00:00
abstract：:Anterior intervertebral fusion increasingly is used as a treatment for discogenic or intersegmental pathologic diseases of the lumbar spine. This is in part attributable to the evolution and refinement of laparoscopic and minimally invasive surgical techniques that now can be used to access the anterior spinal column....
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-200002000-00007
更新日期：2000-02-01 00:00:00
abstract：:Proximal realignment was performed in 75 knees due to patellar pain or instability. With a follow-up period of from two to ten years, the result was excellent or good in 68 knees (91%) and fair or poor in seven knees (9%). Postoperative Merchant views were obtained in 57 knees. In the 52 knees rated good and excellent...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-06-01 00:00:00
abstract：BACKGROUND:Patient-specific cutting blocks have been touted as a more efficient and reliable means of achieving neutral mechanical alignment during TKA with the proposed downstream effect of improved clinical outcomes. However, it is not clear to what degree published studies support these assumptions. QUESTIONS/PURPO...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1007/s11999-014-3804-6
更新日期：2015-01-01 00:00:00
abstract：:Fractures of the proximal femur are, more than ever, an important challenge in the field of traumatology. The Gamma nail, a combination of advantages of the sliding screw with the intramedullary nail, represents an efficient technique in the management of these fractures. A series of 224 fractures of the proximal femu...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1998-05-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000093043.56370.5a
更新日期：2003-12-01 00:00:00
abstract：BACKGROUND:Serum C-reactive protein (CRP) is a general marker of inflammation, and recent studies suggest that measurement of CRP in synovial fluid may be a more accurate method for diagnosing periprosthetic joint infection (PJI). QUESTIONS/PURPOSES:We aimed to (1) determine if there is a correlation between serum and...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-014-3828-y
更新日期：2014-12-01 00:00:00
abstract：:A classification and plan of management for carpal dislocations are presented, based upon the following basic premises: perilunate and lunate dislocations are different stages of the same injury and are therefore managed identically; displacement may be either dorsal or volar; anatomic restoration of the 3 key element...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1980-06-01 00:00:00
abstract：:An improved method of closed irrigation-suction treatment of bone and joint infections is described. The method utilizes a crisscross flow-reversal system using a double tube which prevents obstruction of the tube. A series of 154 patients with acute and chronic bone and joint infections were treated with closed irrig...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1980-05-01 00:00:00
abstract：:The tensile and histologic characteristics of sharply transected Achilles tendons treated by cast immobilization, surgical repair, and surgical repair reinforced with polyglactin mesh were evaluated in 31 rabbits. All modes of tendon treatment resulted in tensile failure at significantly lower loads than in the contra...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-12-01 00:00:00
abstract：:Femoral head collapse occurred in a 20-year-old ballet dancer with anorexia nervosa. The patient developed anorexia nervosa at the age of 11 years and had short stature. The condition never resolved, and she developed pain and stiffness in the right hip at the age of 18 years, with documentation of femoral head collap...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-02-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1975-10-01 00:00:00
abstract：:Fractures of the femur in two women, ages 17 and 27, were treated with Brooker-Wills nails. While the distal deployment device was inserted into the nail in one patient, the tip of the driver/inserter broke into the proximal end of the distal deployment device. This complicated the extraction of the nail and the dista...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-05-01 00:00:00
abstract：:High doses of both calcium antagonists and magnesium lead to disorders in the early phase of calcification. Analogous to known mechanisms of calcification outside the bone, the calcium overload of cellular suborganelles, which may play a role in enchondral ossification, is assumed to be prevented or delayed by calcium...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-09-01 00:00:00
abstract：:Thirty intraarticular calcaneal fractures were studied by computed tomography and then treated with a variety of closed methods. A classification of the fractures was devised according to the amount of displacement of the posterior facet. Follow-up evaluation showed that Type I fractures recovered function and healed ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-05-01 00:00:00
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1991-09-01 00:00:00
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journal_title：Clinical orthopaedics and related research
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doi：10.1097/00003086-197511000-00033
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-05-01 00:00:00
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-03-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1989-02-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1976-11-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-07-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1994-07-01 00:00:00
