caa a22 4500 605457603 CHVBK 20210128100224.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s00167-014-3269-x doi (NATIONALLICENCE)springer-10.1007/s00167-014-3269-x Total knee arthroplasty in patients with substantial deformities using primary knee components [Elektronische Daten] [J. De Muylder, J. Victor, O. Cornu, L. Kaminski, E. Thienpont] Purpose: Although advocated for severe varus and valgus deformities, constrained implant designs are associated with a number of disadvantages in total knee arthroplasty (TKA). Combining a minimally invasive surgical approach with an interchangeable posterior stabilized (PS) implant design may allow adequate soft tissue balancing with a minimal amount of constraint and without residual instability. Methods: Retrospectively 51 patients operated with the minimally invasive far medial subvastus approach for severe varus or valgus deformity, who underwent primary TKA with a fully interchangeable PS implant (Vanguard, Biomet Inc., Warsaw IN, USA) between 2009 and 2013 were examined. Soft tissue releases was performed using a piecrust needling technique. Preoperative alignment and surgical parameters were collected for all patients. All patients underwent preoperative and follow-up radiographic assessment and completed a battery of clinical assessments. Results: All procedures were performed successfully, with alignment improving from a preoperative mean (SD) varus deformity of 165° (3°) and a mean (SD) valgus deformity of 196° (4.5°) to an overall mean (SD) postoperative mechanical alignment of 179.5° (3.0°). Nine patients had postoperative varus, while three patients had a postoperative valgus deviation from neutral alignment >3°. The mean change in joint line position in extension was −0.0±0.6mm. Clinical scores at final follow-up were excellent for both groups. Conclusions: Good TKA outcomes can be achieved in patients with substantial varus or valgus deformities using a combination of a minimally invasive far medial subvastus approach, interchangeable PS implants and soft tissue releases with a piecrust needling technique. Level of evidence: III. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA), 2014 Total knee arthroplasty nationallicence Minimally invasive surgery nationallicence Posterior stabilized nationallicence Prosthesis design nationallicence Joint deformity nationallicence De Muylder J. Department of Orthopaedic Surgery, Cliniques universitaires Saint Luc-UCL, Av. Hippocrate 10, 1200, Brussels, Belgium aut Victor J. Department of Orthopaedic Surgery, UZ Gent, Ghent, Belgium aut Cornu O. Department of Orthopaedic Surgery, Cliniques universitaires Saint Luc-UCL, Av. Hippocrate 10, 1200, Brussels, Belgium aut Kaminski L. Department of Orthopaedic Surgery, Cliniques universitaires Saint Luc-UCL, Av. Hippocrate 10, 1200, Brussels, Belgium aut Thienpont E. Department of Orthopaedic Surgery, Cliniques universitaires Saint Luc-UCL, Av. Hippocrate 10, 1200, Brussels, Belgium aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/12(2015-12-01), 3653-3659 0942-2056 23:12<3653 2015 23 167 https://doi.org/10.1007/s00167-014-3269-x text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-014-3269-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- De Muylder J. Department of Orthopaedic Surgery, Cliniques universitaires Saint Luc-UCL, Av. Hippocrate 10, 1200, Brussels, Belgium aut NATIONALLICENCE 700 1- Victor J. Department of Orthopaedic Surgery, UZ Gent, Ghent, Belgium aut NATIONALLICENCE 700 1- Cornu O. Department of Orthopaedic Surgery, Cliniques universitaires Saint Luc-UCL, Av. Hippocrate 10, 1200, Brussels, Belgium aut NATIONALLICENCE 700 1- Kaminski L. Department of Orthopaedic Surgery, Cliniques universitaires Saint Luc-UCL, Av. Hippocrate 10, 1200, Brussels, Belgium aut NATIONALLICENCE 700 1- Thienpont E. Department of Orthopaedic Surgery, Cliniques universitaires Saint Luc-UCL, Av. Hippocrate 10, 1200, Brussels, Belgium aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/12(2015-12-01), 3653-3659 0942-2056 23:12<3653 2015 23 167