Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Arthroplasty - Knee
Abstract number: 23150
CORRECTING VARUS DEFORMITY DURING TOTAL KNEE ARTHROPLASTY:
THE
"INSIDE-OUT" TECHNIQUE
Chitranjan RANAWAT, Morteza MEFTAH
Hospital for Special Surgery, New York (UNITED STATES)
INTRODUCTION: In 1979, our senior author described this technique for correcting a
flexion contracture during total knee arthroplasty (TKA) by additional resection of the
distal femur and posterior capsular release. Our hypothesis is that this technique
effectively corrects both deformities, while reducing the complications related to the
more traditional techniques. We describe this technique and assess its effectiveness
in a series of 31 consecutive patients. TECHNIQUE: Highlights of this technique are
as follows: 1. An osseous resections of 10mm from the level of the uninvolved
surfaces of the femur and tibia. 2. A transverse release of the contracted posterior
capsule is performed with electrocautery at the level of the tibial resection from the
posterior margin of the superficial medial collateral ligament (MCL) to the
posterolateral corner of the tibia. 3. A controlled lengthening of the superficial MCL
by pie-crusting. RESULTS: Over a 12 month span, we have corrected these biplanar
deformities in 31 knees without residual instability. There were no residual flexion
contractures greater than 5 degrees. The maximum varus corrected was 30
degrees, and the maximum flexion contracture corrected was 20 degrees. The mean
coronal plane correction was to 5.5 degrees of valgus (range: 1 to 9 degrees).
DISCUSSION: In a series of 31 consecutive patients, this technique was effective in
correcting both deformities. We achieved a mean range of motion of 115 degrees,
while avoiding elevation of the joint line or instability. While we report good early
results, further studies are needed to better evaluate this technique.
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