Abstract:
BACKGROUND:Extensive posteromedial release to correct severe varus deformity during TKA may result in mediolateral or flexion instability and may require a constrained implant. We describe a technique combining computer navigation and medial condylar osteotomy in severe varus deformity to achieve a primary goal of ligament balance during TKA. DESCRIPTION OF TECHNIQUE:The goal of this procedure was to achieve mediolateral gap balance in varus knees with rigid, recalcitrant medial contracture, with or without excessive lateral laxity, not amenable to extensive medial soft tissue releases. A sliding medial condylar osteotomy (SMCO) was performed under navigation guidance and the condylar block internally fixed using cancellous screws. METHODS:We prospectively evaluated mediolateral laxity, Knee Society scores, and knee ROM after SMCO in 12 varus arthritic knees in 11 patients (five men, six women) undergoing TKA with a minimum followup of 2 years (mean, 2 years; range, 2-2.5 years). RESULTS:The degree of mediolateral knee laxity improved from Grade 2 (in four knees) and Grade 3 (in eight knees) preoperatively to Grade 1 (< 5 mm) in all knees at last followup. Mean Knee Society score improved from 30 (range, 10-54) to 92 (range, 86-100). Mean knee flexion improved from 106° (range, 90°-120°) to 112° (range, 100°-124°), and no knee had any extensor lag or residual flexion deformity (> 5°). Three knees had asymptomatic fibrous union at the osteotomy site. CONCLUSIONS:Computer-assisted SMCO in varus knees with recalcitrant medial contracture achieves improved mediolateral stability and knee function after TKA. Our technique uses navigation to accurately reposition the medial condylar block to equalize medial and lateral gaps, thereby ensuring a stable well-aligned knee without deploying constrained implants.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Mullaji AB,Shetty GMdoi
10.1007/s11999-012-2773-xsubject
Has Abstractpub_date
2013-05-01 00:00:00pages
1484-91issue
5eissn
0009-921Xissn
1528-1132journal_volume
471pub_type
杂志文章abstract::Spinal traction is a time-honored method for the treatment of disc protrusion, degenerative disc disease, and joint dysfunction. Effective treatment is not as easy or as simple to administer as it may appear. Many variations of technique exist, some of questionable value. It must be emphasized that spinal traction is ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-10-01 00:00:00
abstract::A follow-up study was carried out on 20 patients with a Hitchcock type of biceps tenodesis performed during the past seven years at the Hospital for Special Surgery. Thirteen cases were diagnosed as biceps tendinitis and seven as biceps instability. At follow-up, there was a 30% failure rate; the failures were related...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1982-04-01 00:00:00
abstract::Eighteen hips in 15 children showed persistent roentgenographic evidence of congenital acetabular residual dysplasia at four- to eight-year follow-up evaluations. The mean follow-up period was 5.8 years. These hips were subsequently evaluated by magnetic resonance (MR) imaging. MR imaging studies revealed thick unossi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1991-04-01 00:00:00
abstract:BACKGROUND:Patient-specific CT-based instrumentation may reduce implant malpositioning and improve alignment in TKA. However, it is not known whether this innovation is an advance that benefits patients. QUESTIONS/PURPOSES:We evaluated (1) the precision of patient-specific TKA by comparing the incidence of outliers in...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11999-013-3206-1
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Recently, the authors of two prospective multicenter observational studies recommended surgery to improve head sphericity in older children, whereas large retrospective observational studies suggest that surgery does not improve head sphericity in older children. Thus, the treatment for Legg-Calvé-Perthes di...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s11999-012-2326-3
更新日期:2012-09-01 00:00:00
abstract:UNLABELLED:Grade III Campanacci lesions are traditionally treated with wide resections based on their postulated aggressiveness and potential for local recurrence and metastasis. The purpose of this study was to determine if there was a difference in local recurrence rates of Grade II and III lesions treated with intra...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000180051.27961.c3
更新日期:2005-09-01 00:00:00
abstract::A system has been developed that allows the surgeon to match a prosthesis to any femoral cavity. The surgeon may choose how and where it will preferentially fit. The surgeon does not have to create a cavity to suit a premade prosthesis. The system is based on a novel technique for making a mold of the prepared femoral...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1989-12-01 00:00:00
abstract:BACKGROUND:When considering arthroscopic surgery for treatment of hip pain, it is important to understand the influence of joint degeneration on the likelihood of success. Previous research has shown poorer outcomes among patients with osteoarthritis but new arthroscopic techniques including femoroacetabular impingemen...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-012-2594-y
更新日期:2013-02-01 00:00:00
abstract:UNLABELLED:Risk factors to explain the poor survival of patients with osteosarcoma of the pelvis are poorly understood. Therefore, we attempted to identify factors affecting survival and development of local recurrence and metastasis. We retrospectively reviewed 43 patients who had high-grade pelvic tumors and were tre...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-008-0495-x
更新日期:2009-02-01 00:00:00
abstract::Many patients who have static or only slowly improving neurologic deficits and significant compression of the spinal cord and nerve roots can benefit from anterior decompression. The improvement ranges from partial root recovery to very dramatic improvement in upper as well as lower extremities in the patient with qua...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1981-01-01 00:00:00
abstract::Orthopedic problems are an important feature of the adult, chronic or non-neuropathic form of Gaucher disease. Thirty-five South African patients have been investigated and of these 29 had significant skeletal complications. Twenty-one had nonspecific bone pains, 14 had episodes of pseudoosteomyelitis and 2 had acute ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1978-11-01 00:00:00
abstract::Early diagnosis of adolescent idiopathic scoliosis is essential to prevent severe deformity. The accuracy of thermographic examination of the spine in the detection of minor degrees of curvature has been assessed in 125 asymptomatic young persons mean age 13.4 +/- 0.8 years who were also examined clinically and by spi...
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:BACKGROUND:There is limited information on the complications and costs of conversion THA after hemiarthroplasty for femoral neck fractures. Previous studies have found that patients undergoing conversion THA experience higher risk complications, but it has been difficult to quantify the risk because of small sample siz...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/CORR.0000000000000702
更新日期:2019-06-01 00:00:00
abstract:UNLABELLED:There are many causes of total knee arthroplasty failure, and an accurate preoperative diagnosis is essential to optimize the results of revision surgery. We discuss our standard pre-operative evaluation routine and we retrospectively reviewed the last 295 patients who underwent revision total knee arthropla...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000218727.14097.d5
更新日期:2006-05-01 00:00:00
abstract:UNLABELLED:The anterolateral approach in the supine position provides excellent visualization of the acetabulum. The main advantage of the approach, a low dislocation rate, has been demonstrated in the literature, while the purported disadvantage of abductor dysfunction has not been clearly delineated in the literature...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1007/s11999-008-0523-x
更新日期:2009-01-01 00:00:00
abstract::The etiology of the foot deformity in patients with Charcot-Marie-Tooth disease has not previously been discussed in relation to the extrinsic muscle function around the foot and ankle. Eight adult patients with a strong familial history were evaluated, and their foot findings were remarkably similar. All demonstrated...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract::A long-term clinical study of 41 Flatt metallic hinged prostheses inserted in the metacarpophalangeal joints of ten rheumatoid patients was completed to provide a historic and clinical perspective of the ongoing clinical performance of this prosthesis. Postsurgical analysis performed an average of 138 months after ope...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1984-04-01 00:00:00
abstract:BACKGROUND:Multiple studies have reported favorable short-term results after treatment of spondylolisthesis and other degenerative lumbar diseases with minimally invasive transforaminal lumbar interbody fusion. However, to our knowledge, results at a minimum of 5 years have not been reported. QUESTIONS/PURPOSES:We det...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-013-3241-y
更新日期:2014-06-01 00:00:00
abstract::Benign solitary schwannomas of the foot are a rare occurrence; only four cases have been previously reported. A schwannoma associated with the medial plantar nerve present for more than 40 years before the onset of symptoms was diagnosed in a 73-year-old man. Excision of the mass, with preservation of the involved ner...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1988-03-01 00:00:00
abstract:BACKGROUND:During hip arthroplasties for treating proximal femur metastases, a long femoral stem frequently is used, presumably protecting the entire femur against progression of the existing lesions or development of new lesions. However, it is unclear whether a long stem is really required. QUESTIONS/PURPOSES:We the...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-013-2790-4
更新日期:2013-05-01 00:00:00
abstract::Eight patients with unstable fractures involving the articular surface and metaphyseal-diaphyseal bone of the proximal or distal tibia associated with severe soft-tissue injury or compounding wound were treated with irrigation, debridement, tetanus inoculation, antibiotic prophylaxis, and combined internal fixation wi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1990-07-01 00:00:00
abstract:UNLABELLED:The success of metal-on-metal hip resurfacing in the medium term in young and active patients is becoming evident. The procedure now can be done using a minimal approach developed by the senior author using a single posterior incision. This mini-incision resurfacing arthroplasty of the hip has made resurfaci...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000192034.37049.83
更新日期:2005-12-01 00:00:00
abstract::Reaming increases intramedullary pressure and can cause fat intravasation. This study investigated the influence of reaming parameters on pressure changes using the AO, Gray, and Howmedica reamers. Silicone cylindrical shells with 10-, 11-, 16-, 19-, and 20-mm inner diameters were filled with a 1:2 ratio of paraffin a...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200004000-00036
更新日期:2000-04-01 00:00:00
abstract::By the time a patient's shoulder problem has reached the stage in which an arthrodesis is being considered, the patient usually is willing to accept the restraints of an arthrodesed shoulder. If there is a chance of relieving chronic pain and restoring some reasonable degree of function in the upper extremity, arthrod...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-03-01 00:00:00
abstract::This study was designed to determine the influence of laxity on clinical function after knee replacement. Using a recently developed computerized method, anteroposterior laxities were measured in 29 Insall-Burstein posterior stabilized, 25 Kinemax Condylar (posterior cruciate retaining), and 10 Oxford bicompartmental ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1994-08-01 00:00:00
abstract::Twenty-one patients older than 60 years of age with septic arthritis were reviewed over a ten-year period. The knee was the joint most commonly involved. Concurrent medical illnesses were noted in the majority of patients, with diabetes mellitus present in 24%. Seventy-one percent of patients had roentgenographic evid...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1990-02-01 00:00:00
abstract::Despite widespread acceptance of total knee replacement surgery's clinical effectiveness, variation persists in long-term functional outcome. Our aim was to quantify the relative contributions of physical and emotional coexisting conditions to the variation in improvement in 12-month post-total knee replacement physic...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000185447.43622.93
更新日期:2005-11-01 00:00:00
abstract::A model was developed to identify and compare the local wound factors that induce acute osteomyelitis in a prospective, controlled investigation. When compared with wounds containing either virulent bacteria or dead bone, statistical analysis disclosed a significant increase in the incidence of osteomyelitis when viru...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::To determine the clinical efficacy of an alumina ceramic head, 119 cemented total hip arthroplasties in 97 patients using an alumina head coupled with ethylene oxide gas sterilized polyethylene were reviewed. Eighty-two patients (101 hips) with greater than 10 years followup were evaluated clinically and radiographica...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200110000-00022
更新日期:2001-10-01 00:00:00
abstract::Tibial tubercle avulsions and proximal tibial physeal fractures are uncommon. An even more rare case was seen when an adolescent athlete presented with a combined Type III tibial tubercle avulsion and a Salter-Harris Type IV proximal tibial physeal fracture. There was no previous report in the literature of the combin...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200108000-00027
更新日期:2001-08-01 00:00:00