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Navigation-Assisted Total Knee Arthroplasty for Osteoarthritis with Extra-Articular Femoral Deformity and/or Retained Hardware.

Hamada D, Egawa H, Goto T, Takasago T, Takai M, Hirano T, Kawasaki Y, Yasui N - Case Rep Orthop (2013)

Bottom Line: In addition, atypical bone cut for intra-articular correction leads to imbalanced soft tissue gap.Recently, navigation-assisted TKA has been reported to increase the accuracy of prosthetic positioning and limb alignment.Here, we report 3 successful navigation-assisted TKAs for osteoarthritis with extra-articular deformities and/or retained hardware.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Institute of Health Biosciences, University of Tokushima, Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.

ABSTRACT
Total knee arthroplasty (TKA) for osteoarthritis (OA) patients with extra-articular deformity is still challenging because angular deformity, canal sclerosis, or the retained hardware that precludes the use of the traditional intramedullary guide. In addition, atypical bone cut for intra-articular correction leads to imbalanced soft tissue gap. Furthermore, corrective osteotomy should be considered for severe deformity or para-articular deformity cases. Recently, navigation-assisted TKA has been reported to increase the accuracy of prosthetic positioning and limb alignment. This system can calculate mechanical axis regardless of extra-articular deformity, canal sclerosis, or retained hardware. Accordingly, navigation surgery has been considered to be a powerful option especially in TKAs with extra-articular deformity cases. Here, we report 3 successful navigation-assisted TKAs for osteoarthritis with extra-articular deformities and/or retained hardware. Navigation-assisted TKA is an effective and reliable alternative for patients with extra-articular deformities.

No MeSH data available.


Related in: MedlinePlus

Case 1: preoperative anteroposterior standing radiograph (a) showed an extra-articular valgus deformity (11°) in the femoral shaft. Lateral view (b) revealed 23° antecurvatum deformity in the sagittal plane. Postoperative anteroposterior standing radiograph (c) demonstrated restored mechanical axis. In lateral view (d), femoral component was placed according to the intraoperative navigation data.
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fig1: Case 1: preoperative anteroposterior standing radiograph (a) showed an extra-articular valgus deformity (11°) in the femoral shaft. Lateral view (b) revealed 23° antecurvatum deformity in the sagittal plane. Postoperative anteroposterior standing radiograph (c) demonstrated restored mechanical axis. In lateral view (d), femoral component was placed according to the intraoperative navigation data.

Mentions: A 61-year-old man was involved in a motor vehicle accident at the age of 31. He sustained a left open femoral shaft fracture, and was treated with open reduction and internal fixation. Despite the treatment, the fracture was malunited and valgus deformity of the femoral shaft remained. Progressive left knee pain appeared 3 years before presentation. He was referred to us for surgery. Radiographs showed advanced degenerative arthritis of the left knee and malunited left femoral shaft fracture (Figures 1(a) and 1(b)). There was a 11° valgus in coronal plane and 23° antecurvatum deformity in sagittal plane preoperatively.


Navigation-Assisted Total Knee Arthroplasty for Osteoarthritis with Extra-Articular Femoral Deformity and/or Retained Hardware.

Hamada D, Egawa H, Goto T, Takasago T, Takai M, Hirano T, Kawasaki Y, Yasui N - Case Rep Orthop (2013)

Case 1: preoperative anteroposterior standing radiograph (a) showed an extra-articular valgus deformity (11°) in the femoral shaft. Lateral view (b) revealed 23° antecurvatum deformity in the sagittal plane. Postoperative anteroposterior standing radiograph (c) demonstrated restored mechanical axis. In lateral view (d), femoral component was placed according to the intraoperative navigation data.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3794565&req=5

fig1: Case 1: preoperative anteroposterior standing radiograph (a) showed an extra-articular valgus deformity (11°) in the femoral shaft. Lateral view (b) revealed 23° antecurvatum deformity in the sagittal plane. Postoperative anteroposterior standing radiograph (c) demonstrated restored mechanical axis. In lateral view (d), femoral component was placed according to the intraoperative navigation data.
Mentions: A 61-year-old man was involved in a motor vehicle accident at the age of 31. He sustained a left open femoral shaft fracture, and was treated with open reduction and internal fixation. Despite the treatment, the fracture was malunited and valgus deformity of the femoral shaft remained. Progressive left knee pain appeared 3 years before presentation. He was referred to us for surgery. Radiographs showed advanced degenerative arthritis of the left knee and malunited left femoral shaft fracture (Figures 1(a) and 1(b)). There was a 11° valgus in coronal plane and 23° antecurvatum deformity in sagittal plane preoperatively.

Bottom Line: In addition, atypical bone cut for intra-articular correction leads to imbalanced soft tissue gap.Recently, navigation-assisted TKA has been reported to increase the accuracy of prosthetic positioning and limb alignment.Here, we report 3 successful navigation-assisted TKAs for osteoarthritis with extra-articular deformities and/or retained hardware.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Institute of Health Biosciences, University of Tokushima, Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.

ABSTRACT
Total knee arthroplasty (TKA) for osteoarthritis (OA) patients with extra-articular deformity is still challenging because angular deformity, canal sclerosis, or the retained hardware that precludes the use of the traditional intramedullary guide. In addition, atypical bone cut for intra-articular correction leads to imbalanced soft tissue gap. Furthermore, corrective osteotomy should be considered for severe deformity or para-articular deformity cases. Recently, navigation-assisted TKA has been reported to increase the accuracy of prosthetic positioning and limb alignment. This system can calculate mechanical axis regardless of extra-articular deformity, canal sclerosis, or retained hardware. Accordingly, navigation surgery has been considered to be a powerful option especially in TKAs with extra-articular deformity cases. Here, we report 3 successful navigation-assisted TKAs for osteoarthritis with extra-articular deformities and/or retained hardware. Navigation-assisted TKA is an effective and reliable alternative for patients with extra-articular deformities.

No MeSH data available.


Related in: MedlinePlus