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ORIGINAL ARTICLE
Year : 2016  |  Volume : 51  |  Issue : 4  |  Page : 329-332

Total knee replacement in severe varus and flexion knee deformities using economical solutions


Department of Orthopaedics and Traumatology, Faculty of Medicine, Assiut University, Assiut, Egypt

Correspondence Address:
Hatem M.A Bakr
Lecturer Of Orthopaedics and Traumatology, Department of Orthopaedics and Traumatology, Faculty of Medicine, Assiut University, Assiut
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-1148.209001

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Background Total knee replacement in severe deformities is a challenging procedure. Varus and flexion are the commonest deformities seen. Thorough soft tissue release and balancing is the key to a successful outcome. We tried to correct these cases without the need for expensive augments and specialized prosthesis. Aim of the work The purpose of this study is to offer economical solution for severe varus and flexion knee deformity and perform a follow-up. This was achieved by using bone grafts from the cuts, proper tissue release, and good preoperative and intraoperative assessment. Patients and methods Our study included 30 knees in 23 patients with severe flexion and varus deformities. The average preoperative varus deformity was 20° (range: 14°–38°), and the average flexion deformity was 15.6° (range: 5°–30°). Bone graft was used in eight (26%) cases and tibial stems in two (6%) cases. No constrained prosthesis was used. Results The average follow-up was 31 months (range: 8–65 months). The average postoperative range of flexion was 115° (range: 90°–147°), range of extension was between 0° and 6°, and the average varus correction was 26° (range: 12°–42°). At the final follow-up, we had 15 excellent, 12 good, two fair, and one poor functional result, giving a 90% success rate. Conclusion Total knee arthroplasty is a challenging procedure in severe grade of knee deformity. Different surgical facilities and solutions must be available to achieve optimum results. Although a wide scale of prosthesis types and bone defect replacement has been used in treating these cases, we were able to treat them with minimal cost and good results.


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