Laxity after complete release of the medial collateral ligament in primary total knee arthroplasty

被引:25
作者
Cho, Woo-Shin [1 ]
Byun, Seong-Eun [2 ]
Lee, Sang-Jun [3 ]
Yoon, Jaeyoun [1 ]
机构
[1] Univ Ulsan, Dept Orthopaed Surg, Asan Med Ctr, Coll Med, Seoul, South Korea
[2] CHA Univ, Dept Orthopaed Surg, CHA Bundang Med Ctr, Coll Med, Songnam, Gyeonggi Do, South Korea
[3] Teunteun Hosp, Dept Orthopaed Surg, Guri Si, Gyeonggi Do, South Korea
关键词
Complete medial collateral ligament release; Ligament balancing; Total knee arthroplasty; VARUS DEFORMITY; FOLLOW-UP; COMPLETE TEARS; REPLACEMENT; INSTABILITY; PROSTHESIS; VALGUS;
D O I
10.1007/s00167-014-3288-7
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
100224 [整形外科学];
摘要
Medial collateral ligament (MCL) release is one of the essential steps toward the achievement of ligament balancing during the total knee arthroplasty (TKA) in patients with varus deformity. When the varus deformity is severe, complete release of the MCL until balanced is often required. However, it is believed that complete MCL release may lead to catastrophic laxity. The purpose of this prospective study is to compare the medial joint gap opening in postoperative valgus stress radiograph in patients with complete MCL release against patients with partial release. Out of 209 primary TKAs performed for degenerative osteoarthritis, complete MCL release was required in 33 cases (group I) by sub-periosteal detachment at proximal tibia using periosteal elevator. For the remaining 176 knees (group II), partial release of MCL was done. At postoperative 6 months and 1 year, both groups were evaluated for comparing the joint gap on valgus stress radiographs using modified Telos device in 0A degrees, 45A degrees, and 90A degrees of flexion. Additional parameters which were analyzed included preoperative varus and valgus stress radiographs in full extension and pre- and postoperative mechanical alignment in each group. The knee range of motion (ROM) and clinical scores were evaluated at 1-year follow-up. The mean values of the joint opening on the postoperative valgus stress test with the knee joint extended, and in the 45A degrees and 90A degrees flexed states at 6 months and at 1 year postoperatively in group I were not statistically significantly different from those of group II. The clinical scores also did not show a statistically significant difference between two groups. There was a statistically significant difference in ROM between two groups, pre- and postoperatively and the difference was 5A degrees, respectively. This study suggests that complete MCL release for ligament balancing is a safe procedure and does not lead to postoperative laxity.
引用
收藏
页码:1816 / 1823
页数:8
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