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[Total knee arthroplasty by lateral parapatellar approach for valgus knee].
Zhonghua Yi Xue Za Zhi. 2007 Jul 17; 87(27):1885-9.ZY

Abstract

OBJECTIVE

To investigate the effect of lateral parapatellar approach in total knee arthroplasty (TKA) of valgus knee.

METHODS

Lateral parapatellar approach of total knee arthroplasty was applied in 8 patients (10 knees) with severe valgus osteoarthritis knee (bilateral in 2 cases and unilateral in 6 cases), with the valgus angle > 15 degrees , 1 male (1 knee) and 7 females (9 knee), aged 68.2 (58 - 79), 7 cases (9 knees) being of the Krackow type I and 1 case (1 knee) of the Krackow type I, I. After incision of the skin through lateral knee, ilio-tibial band was prolonged by apple pie arthroplasty. The joint capsule was cut open laterally 2 - 4 cm from the para-patellar edge. Soft tissue balance was performed by releasing I - T band in Gerdy tubercle, lateral collateral ligament and poster-lateral capsule from the femur and tibial side. Valgus angle of distal femur cutting were five degree. Whiteside line and trans-epicondylar line were used as AP rotational cutting reference. All patellar of the group were resurfaced. Capsule closure is completed with the knee flexed. The expanded deep lateral soft tissue sleeve (coronal Z-plasty) is sutured with the medial retinaculum sleeve (superficial layer). Follow-up was conducted for 19.6 months (1 - 51 months).

RESULTS

Seven cases (9 knees) were replaced by posterior stabilized cemented prostheses (TC-Dynamic, PLUS), one case (1 knee) was replaced by RT prosthesis (RT-PLUS(TM) Solution, PLUS). After operation, the valgus deformity of all patients was corrected and all patients could walk 100 m with or without the help of walking holders. The average range of motion (ROM) was improved from the pre-operative. 95.6 degrees (85 degrees - 110 degrees) to the post-operative 117.1 degrees (100 degrees - 125 degrees). The average femorotibial angle (FTA) was corrected from the pre-operative. 27.6 degrees (20 degrees - 40 degrees) to the post-operative 6.8 degrees (5 degrees - 9 degrees). The Knee Score System (KSS) score and functional score were improved from the pre-operative 22.7 points (9 - 48 points) and 26.5 points (12 - 55 points) to the post-operative 86.4 points (85 - 95 points) and 89.1 points (80 - 95 points) respectively. Follow-up showed that the FTA remained unchanged and the knee stability of all patients was good.

CONCLUSION

Through lateral approach, "Z" plasty of the capsule can release the lateral structure and decrease the pressure of common peroneal nerve. For TKR with moderate to severe fixed valgus knee, lateral approach is an effective way to correct the deformity.

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Publisher Full Text

Authors+Show Affiliations

Zhou DG
Arthritis Clinic and Research Center, Peking University People's Hospital, Beijing 100044, China.
Zhang B
No affiliation info available
Kou BL
No affiliation info available
Lü HS
No affiliation info available

MeSH

AgedArthroplasty, Replacement, KneeFemaleFollow-Up StudiesHumansKnee JointKnee ProsthesisMaleMiddle AgedOsteoarthritis, KneePatella

Pub Type(s)

English Abstract
Journal Article

Language

chi

PubMed ID

17923009

Citation

Zhou, Dian-ge, et al. "[Total Knee Arthroplasty By Lateral Parapatellar Approach for Valgus Knee]." Zhonghua Yi Xue Za Zhi, vol. 87, no. 27, 2007, pp. 1885-9.
Zhou DG, Zhang B, Kou BL, et al. [Total knee arthroplasty by lateral parapatellar approach for valgus knee]. Zhonghua Yi Xue Za Zhi. 2007;87(27):1885-9.
Zhou, D. G., Zhang, B., Kou, B. L., & Lü, H. S. (2007). [Total knee arthroplasty by lateral parapatellar approach for valgus knee]. Zhonghua Yi Xue Za Zhi, 87(27), 1885-9.
Zhou DG, et al. [Total Knee Arthroplasty By Lateral Parapatellar Approach for Valgus Knee]. Zhonghua Yi Xue Za Zhi. 2007 Jul 17;87(27):1885-9. PubMed PMID: 17923009.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Total knee arthroplasty by lateral parapatellar approach for valgus knee]. AU - Zhou,Dian-ge, AU - Zhang,Bin, AU - Kou,Bo-long, AU - Lü,Hou-shan, PY - 2007/10/10/pubmed PY - 2008/11/1/medline PY - 2007/10/10/entrez SP - 1885 EP - 9 JF - Zhonghua yi xue za zhi JO - Zhonghua Yi Xue Za Zhi VL - 87 IS - 27 N2 - OBJECTIVE: To investigate the effect of lateral parapatellar approach in total knee arthroplasty (TKA) of valgus knee. METHODS: Lateral parapatellar approach of total knee arthroplasty was applied in 8 patients (10 knees) with severe valgus osteoarthritis knee (bilateral in 2 cases and unilateral in 6 cases), with the valgus angle > 15 degrees , 1 male (1 knee) and 7 females (9 knee), aged 68.2 (58 - 79), 7 cases (9 knees) being of the Krackow type I and 1 case (1 knee) of the Krackow type I, I. After incision of the skin through lateral knee, ilio-tibial band was prolonged by apple pie arthroplasty. The joint capsule was cut open laterally 2 - 4 cm from the para-patellar edge. Soft tissue balance was performed by releasing I - T band in Gerdy tubercle, lateral collateral ligament and poster-lateral capsule from the femur and tibial side. Valgus angle of distal femur cutting were five degree. Whiteside line and trans-epicondylar line were used as AP rotational cutting reference. All patellar of the group were resurfaced. Capsule closure is completed with the knee flexed. The expanded deep lateral soft tissue sleeve (coronal Z-plasty) is sutured with the medial retinaculum sleeve (superficial layer). Follow-up was conducted for 19.6 months (1 - 51 months). RESULTS: Seven cases (9 knees) were replaced by posterior stabilized cemented prostheses (TC-Dynamic, PLUS), one case (1 knee) was replaced by RT prosthesis (RT-PLUS(TM) Solution, PLUS). After operation, the valgus deformity of all patients was corrected and all patients could walk 100 m with or without the help of walking holders. The average range of motion (ROM) was improved from the pre-operative. 95.6 degrees (85 degrees - 110 degrees) to the post-operative 117.1 degrees (100 degrees - 125 degrees). The average femorotibial angle (FTA) was corrected from the pre-operative. 27.6 degrees (20 degrees - 40 degrees) to the post-operative 6.8 degrees (5 degrees - 9 degrees). The Knee Score System (KSS) score and functional score were improved from the pre-operative 22.7 points (9 - 48 points) and 26.5 points (12 - 55 points) to the post-operative 86.4 points (85 - 95 points) and 89.1 points (80 - 95 points) respectively. Follow-up showed that the FTA remained unchanged and the knee stability of all patients was good. CONCLUSION: Through lateral approach, "Z" plasty of the capsule can release the lateral structure and decrease the pressure of common peroneal nerve. For TKR with moderate to severe fixed valgus knee, lateral approach is an effective way to correct the deformity. SN - 0376-2491 UR - https://www.unboundmedicine.com/medline/citation/17923009/[Total_knee_arthroplasty_by_lateral_parapatellar_approach_for_valgus_knee]_ L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&issn=0376-2491&year=2007&vol=87&issue=27&fpage=1885 DB - PRIME DP - Unbound Medicine ER -