Abstract
Aims
The aims of this prospective study were to determine the effect of osteophyte excision on deformity correction and soft- tissue gap balance in varus knees undergoing total knee arthroplasty (TKA).
Patients and Methods
Limb deformity in coronal (varus) and sagittal (flexion) planes, medial and lateral gap distances in maximum knee extension and 90° knee flexion and maximum knee flexion were recorded before and after excision of medial femoral and tibial osteophytes using computer navigation in 164 patients who underwent 221 computer-assisted, cemented, cruciate- substituting TKAs.
Results
Mean varus and flexion deformities of 4.5°±3° (0.5° to 30° varus) and 4.9°±5.9° (−15° hyperextension to 30° flexion) reduced significantly (p<0.0001) to mean varus deformity of 1°±2.3° and mean flexion deformity of 2.7°±4.2° after excision of medial femoral and tibial osteophytes. The mean medio-lateral (ML) soft-tissue gap difference in maximum knee extension and 90°knee flexion of 2.7±3.6mm and 0.7±2.6mm reduced significantly (p<0.0001) to mean ML soft-tissue gap difference of 0.7±2.5mm in maximum knee extension and 0.1±1.9mm in 90°knee flexion. The mean maximum knee flexion (122.8°±8.4°) increased significantly to mean maximum knee flexion of (125°±8°).
Conclusion
Excision of medial femoral and tibial osteophytes during TKA in varus knees significantly improves varus and flexion deformities, mediolateral soft-tissue gap imbalance in maximum extension and in 90°knee flexion and maximum knee flexion.
Clinical Relevance
Excision of medial femoral and tibial osteophytes can be a useful, initial step towards achieving deformity correction and gap balance without having to resort to soft-tissue release during TKA in varus knees.
