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Extra-articular tibial deformity management in total knee replacement / Sanjeev Agarwal in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)
[article]
Titre : Extra-articular tibial deformity management in total knee replacement Type de document : texte imprimé Auteurs : Sanjeev Agarwal ; Sarah Choi ; Rakesh Kumar Année de publication : 2021 Article en page(s) : p. 659-664 Note générale : https://doi.org/10.52628/87.4.11 Langues : Anglais (eng) Mots-clés : Knee replacement knee arthroplasty tibia malunion tibia deformity Résumé : Background : Presence of an extra-articular deformity in the femur or tibia poses a challenge to the surgeon undertaking knee replacement procedure. The conundrum is whether to correct the deformity beforehand, or accept the deformity and compensate for this through placement of the implant.
Material and Methods : This is a retro-spective study comprising six patients who had a knee replacement in the presence of an extra-articular deformity of the tibia treated at our centre. All six had the knee replacement without correction of deformity. The data evaluated included clinical outcome, mechanical axis correction, type of implant, and the use of any software / computer guidance.
The deformity was managed through planning of tibial resection without the need for pre-operative deformity correction.
Results : Mean age was 66.5 years. Mean coronal plane deformity in the tibia was 8.6 degrees. The hip- knee-ankle improved from a mean 12.6 degrees to 4 degrees. Mean Oxford knee score improved from a mean of 19 to 33.6.
Conclusion : Planning the tibial resection on the basis of mechanical axis of tibia allows correction of alignment without the need for preoperative correction.
Correction of the deformity may not be needed if the maximum tibial resection is less than 15 mm.Permalink : ./index.php?lvl=notice_display&id=102016
in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 659-664[article] Extra-articular tibial deformity management in total knee replacement [texte imprimé] / Sanjeev Agarwal ; Sarah Choi ; Rakesh Kumar . - 2021 . - p. 659-664.
https://doi.org/10.52628/87.4.11
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 659-664
Mots-clés : Knee replacement knee arthroplasty tibia malunion tibia deformity Résumé : Background : Presence of an extra-articular deformity in the femur or tibia poses a challenge to the surgeon undertaking knee replacement procedure. The conundrum is whether to correct the deformity beforehand, or accept the deformity and compensate for this through placement of the implant.
Material and Methods : This is a retro-spective study comprising six patients who had a knee replacement in the presence of an extra-articular deformity of the tibia treated at our centre. All six had the knee replacement without correction of deformity. The data evaluated included clinical outcome, mechanical axis correction, type of implant, and the use of any software / computer guidance.
The deformity was managed through planning of tibial resection without the need for pre-operative deformity correction.
Results : Mean age was 66.5 years. Mean coronal plane deformity in the tibia was 8.6 degrees. The hip- knee-ankle improved from a mean 12.6 degrees to 4 degrees. Mean Oxford knee score improved from a mean of 19 to 33.6.
Conclusion : Planning the tibial resection on the basis of mechanical axis of tibia allows correction of alignment without the need for preoperative correction.
Correction of the deformity may not be needed if the maximum tibial resection is less than 15 mm.Permalink : ./index.php?lvl=notice_display&id=102016 Réservation
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DisponibleGenu valgum deformity – correction by a wedgeless implantless femoral “V” osteotomy / Amrit Goyal in Acta Orthopaedica Belgica, Vol.87/2 (Juin 2021)
[article]
Titre : Genu valgum deformity – correction by a wedgeless implantless femoral “V” osteotomy Type de document : texte imprimé Auteurs : Amrit Goyal ; Vikas Gupta ; Meenakshi Goyal ; Rajesh Chandra ; Vinod K. Sharma Année de publication : 2021 Article en page(s) : p. 247-254 Note générale : https://doi.org/10.52628/87.2.07 Langues : Anglais (eng) Mots-clés : genu valgum osteotomy deformity paediatric knee Résumé : Coronal malalignment of the knee joint is very common in developing countries especially because of nutritional rickets. Significant valgus deformity needs to be treated surgically to improve appearance, gait and function of the patient. The purpose of this prospective study was to evaluate the results of supracondylar “V” osteotomy as a surgical technique for correction of the valgus knee deformity.
This study was conducted in a tertiary level teaching hospital and 30 cases were included in the study. For all the patients deformity was assessed using ana- tomical tibiofemoral angle, mechanical axis deviation and intermalleolar distance preoperatively and post- operatively.
The average age of our patients was 13.7 years and the average follow up was3.29 years (1.39-14.22 yrs). Clinically the average value of intermalleolar distance preoperatively was 16cm and 3.2 cm postperatively. Average pre-operative tibiofemoral angle was 23° and the average postoperative angle was 6 0 which was found to be statistically significant using the Paired t test (p<0.005). The average value of preoperative mechanical axis deviation was 3.1 cm which decreased to an average value of 1.1 cm postoperatively.
The results with this technique have been encouraging. The advantages of this technique are low morbidity, good stability allowing early ambulation, ability to adjust alignment postoperatively by casting and no need for internal fixation. Few studies have been conducted on osteotomies that do not require internal fixation and are inherently stable. This technique has the advantage of practically no occurrence of any infection or a second surgery to remove hardware in children and adolescents. Since no specialized instrumentation, image intensifier and implants are required, it is cost effective and can be used in any primary care or district level surgical setup in a developing country like ours.Permalink : ./index.php?lvl=notice_display&id=96627
in Acta Orthopaedica Belgica > Vol.87/2 (Juin 2021) . - p. 247-254[article] Genu valgum deformity – correction by a wedgeless implantless femoral “V” osteotomy [texte imprimé] / Amrit Goyal ; Vikas Gupta ; Meenakshi Goyal ; Rajesh Chandra ; Vinod K. Sharma . - 2021 . - p. 247-254.
https://doi.org/10.52628/87.2.07
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol.87/2 (Juin 2021) . - p. 247-254
Mots-clés : genu valgum osteotomy deformity paediatric knee Résumé : Coronal malalignment of the knee joint is very common in developing countries especially because of nutritional rickets. Significant valgus deformity needs to be treated surgically to improve appearance, gait and function of the patient. The purpose of this prospective study was to evaluate the results of supracondylar “V” osteotomy as a surgical technique for correction of the valgus knee deformity.
This study was conducted in a tertiary level teaching hospital and 30 cases were included in the study. For all the patients deformity was assessed using ana- tomical tibiofemoral angle, mechanical axis deviation and intermalleolar distance preoperatively and post- operatively.
The average age of our patients was 13.7 years and the average follow up was3.29 years (1.39-14.22 yrs). Clinically the average value of intermalleolar distance preoperatively was 16cm and 3.2 cm postperatively. Average pre-operative tibiofemoral angle was 23° and the average postoperative angle was 6 0 which was found to be statistically significant using the Paired t test (p<0.005). The average value of preoperative mechanical axis deviation was 3.1 cm which decreased to an average value of 1.1 cm postoperatively.
The results with this technique have been encouraging. The advantages of this technique are low morbidity, good stability allowing early ambulation, ability to adjust alignment postoperatively by casting and no need for internal fixation. Few studies have been conducted on osteotomies that do not require internal fixation and are inherently stable. This technique has the advantage of practically no occurrence of any infection or a second surgery to remove hardware in children and adolescents. Since no specialized instrumentation, image intensifier and implants are required, it is cost effective and can be used in any primary care or district level surgical setup in a developing country like ours.Permalink : ./index.php?lvl=notice_display&id=96627 Exemplaires (1)
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Exclu du prêtFate Of Kyphosis In Tuberculosis Of Subaxial Cervical Spine Treated Non-Operatively / Aditya AGGARWAL in Acta Orthopaedica Belgica, Vol 80/4 (Décembre 2014)
[article]
Titre : Fate Of Kyphosis In Tuberculosis Of Subaxial Cervical Spine Treated Non-Operatively Type de document : texte imprimé Auteurs : Aditya AGGARWAL, Auteur Année de publication : 2014 Article en page(s) : p.451-456 Langues : Anglais (eng) Mots-clés : cervical spine tuberculosis kyphotic deformity non operative treatment Résumé : Study design : Retrospective study Objective : Observation of post treatment kyphotic angle in patient of cervical spine tuberculosis managed non operatively Background : The incidence of tuberculosis of cervical spine is about 6-9%. The most dreaded complications of spinal tuberculosis are neural involvement and spinal deformity. Due to destruction of the vertebra tuberculosis of spine usually leads to variable amount of kyphotic deformity. Methods : We retrospectively reviewed 13 patients with clinico-radiological diagnosis of cervical spine tuberculosis managed in our centre between 2004 to 2011. The patients were started on antitubercular therapy. Crutchfield tongs traction was applied 8 to 12 weeks followed by mobilization with four post collar. The kyphotic angles were measured by radiograph at presentation and last available follow up radiograph. Observations : The mean age of the patients was 20 years. C3-C4 vertebra was the most commonly involved area. One patient had single vertebra involvement, five patients had two vertebrae involvement, five patients had three vertebrae involvement and two patients had four vertebrae involvement. The average number of vertebrae involved was 2.6 vertebrae. 9 out of 13 patients had neural deficit at the time of initial presentation. The mean follow up was 21.23 months (12 to 42 months). All patients responded favorably and had neural recovery. At final follow up, 10 out of 13 patients had improvement in kyphotic angle, two patients had deterioration of kyphotic angle and one patient had no change in kyphotic angle. Only one patient had significant deterioration in kyphotic angle. Conclusion : Non operative treatment of cervical spine tuberculosis by initial traction and antitubercular therapy improves the pretreatment deformity irrespective of the number of vertebra involved. Permalink : ./index.php?lvl=notice_display&id=34663
in Acta Orthopaedica Belgica > Vol 80/4 (Décembre 2014) . - p.451-456[article] Fate Of Kyphosis In Tuberculosis Of Subaxial Cervical Spine Treated Non-Operatively [texte imprimé] / Aditya AGGARWAL, Auteur . - 2014 . - p.451-456.
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol 80/4 (Décembre 2014) . - p.451-456
Mots-clés : cervical spine tuberculosis kyphotic deformity non operative treatment Résumé : Study design : Retrospective study Objective : Observation of post treatment kyphotic angle in patient of cervical spine tuberculosis managed non operatively Background : The incidence of tuberculosis of cervical spine is about 6-9%. The most dreaded complications of spinal tuberculosis are neural involvement and spinal deformity. Due to destruction of the vertebra tuberculosis of spine usually leads to variable amount of kyphotic deformity. Methods : We retrospectively reviewed 13 patients with clinico-radiological diagnosis of cervical spine tuberculosis managed in our centre between 2004 to 2011. The patients were started on antitubercular therapy. Crutchfield tongs traction was applied 8 to 12 weeks followed by mobilization with four post collar. The kyphotic angles were measured by radiograph at presentation and last available follow up radiograph. Observations : The mean age of the patients was 20 years. C3-C4 vertebra was the most commonly involved area. One patient had single vertebra involvement, five patients had two vertebrae involvement, five patients had three vertebrae involvement and two patients had four vertebrae involvement. The average number of vertebrae involved was 2.6 vertebrae. 9 out of 13 patients had neural deficit at the time of initial presentation. The mean follow up was 21.23 months (12 to 42 months). All patients responded favorably and had neural recovery. At final follow up, 10 out of 13 patients had improvement in kyphotic angle, two patients had deterioration of kyphotic angle and one patient had no change in kyphotic angle. Only one patient had significant deterioration in kyphotic angle. Conclusion : Non operative treatment of cervical spine tuberculosis by initial traction and antitubercular therapy improves the pretreatment deformity irrespective of the number of vertebra involved. Permalink : ./index.php?lvl=notice_display&id=34663 Exemplaires (1)
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