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Briard Jl. How To Correct Extra Articular Deformity. Slide 15 26
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Briard Jl. How To Correct Extra Articular Deformity. Slide 15 26

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  • 1.
    • in flexion:
    • released, elongated LCL may be weak
    • (danger of instability)
    • Rotate the femoral implant in exagerated ER to be stable
    NB: due to the release: tibial cut & Trans Epicondylar Axis are not even // !
  • 2.
    • think of lateral condyle osteotomy to have strong lateral structures at the right length
    Lateral collateral ligament release (saving popliteus tendon) P
  • 3. 2nd MESSAGE
    • MEDIAL RELEASE is a safe & easy technique with a good sleeve
    • LATERAL RELEASE is difficult and carry a high risk of secondary FT instability and may require more constrained designs (or PCR)
  • 4. The effect of Extraarticular Varus & Valgus Deformity on TKA A.Wolff, D.Hungerford, C.Pepe Clin.Orthop. 271: 35-51, 1991 MALUNIONS
  • 5. the closer to the knee (like HTO) the more is the consequent malorientation of the knee 25° HKA: 176° HKA: 159°
  • 6.
    • If you want to create coronal laxity in extension , you must e longate, release :
    • Iry & I I ry stabilizers in extension
    • Medially:
    • MCL
    • ACL + PCL
    • Posterior capsule
    • (severe destabilization)
    INTRAARTICULAR CORRECTION of EA DEFORMITY 3rd MESSAGE
  • 7. FEMUR VARUM
    • consider:
    • medial release, magnitude
    • distal resection of lateral condyle
    • OK in extension but….
    +
  • 8.
    • Rotate the femoral implant in IR
    • subluxation of the Patella
    but in flexion in order to be stable: + IR + IR
  • 9.
    • if significant femur varum :
    • think of a tibial cut in slight valgus
    • a metaphyseal femoral osteotomy
    • or a medial condylar osteotomy with flexion gap first and then bring the osteotomized MC distally
  • 10. Femur Varum HKA 162°
  • 11.  
  • 12. TIBIA VALGUM
    • consider :
    • Tibia (no consequence in F for the rotation of the femoral implant)
    • collateral lgts frame hinge perpendicular
    • Valgum= lateral release necessary to create laxity in full extension