KEN OKAZAKI
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Professor and Division head
Article types Original article
Language English
Peer review Peer reviewed
Title Medial soft tissue contracture does not always exist in varus osteoarthritis knees in total knee arthroplasty.
Journal Formal name:Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
Abbreviation:Knee Surg Sports Traumatol Arthrosc
ISSN code:14337347/09422056
Domestic / ForeginForegin
Volume, Issue, Page 27(5),pp.1642-1650
Author and coauthor Ushio Tetsuro†, Mizu-Uchi Hideki, Okazaki Ken, Miyama Kazuki, Akasaki Yukio, Ma Yuan, Nakashima Yasuharu
Publication date 2019/05
Summary PURPOSE:To evaluate preoperative soft tissue balance for total knee arthroplasty (TKA), varus/valgus stress radiographs has been used in previous studies. While the joint line of femur and tibia is almost parallel in healthy and postoperative knees, osteoarthritis (OA) knees exhibit articular cartilage wear that causes the joint line tilting even in a non-stress condition. Therefore, the exact angle of the joint line might mislead to understand the joint laxity in OA knees. The purpose of this study was to evaluate soft tissue balance in varus OA knees using preoperative stress radiographs under three different constant loads, taking the articular cartilage wear into consideration.METHODS:One hundred and eighteen varus-deformed OA knees in 102 patients were investigated before primary TKA. Preoperative knee radiographs were obtained in the anteroposterior view with no stress (defined as the neutral condition) and with varus and valgus stresses (5, 10, and 15 kg) in extension. Two different types of joint line angle (JLA), the absolute JLA (an exact angle of joint line) and the relative JLA (the absolute JLA minus the JLA in the neutral condition), were compared for the same load with the paired t test.RESULTS:The absolute JLA was 7.9 ± 1.2°/- 1.5 ± 2.2° under varus/valgus 15 kg stress, 6.7 ± 2.4°/- 0.3 ± 2.1° under varus/valgus 10 kg stress, and 4.7 ± 2.4°/1.1 ± 2.2° under varus/valgus 5 kg stress. Significant differences in the numerical values of the absolute JLA were observed between varus and valgus stresses for each load. The neutral JLA was 3.2 ± 2.0°.
DOI 10.1007/s00167-018-5276-9
PMID 30402662