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Management of Extra-articular Deformity

  • Giles R. Scuderi
  • Steven B. Haas
  • Jonathan L. Berliner
  • Michael J. Assayag
  • S. Robert RozbruchEmail author
  • Anton Khlopas
  • Grayson P. Connors
  • Chukwuweike U. Gwam
  • Jaydev B. Mistry
  • Ronald E. Delanois
  • Michael A. MontEmail author
  • Bertrand W. Parcells
  • Dexter K. Bateman
  • Jared S. Preston
  • Alfred J. Tria
Chapter

Abstract

Total knee arthroplasty (TKA) in the presence of severe extra-articular deformity remains a challenging situation. Such deformities mainly occurring secondary to femoral or tibial fracture malunion, failed osteotomy, prior physeal injury, congenital deformity, metabolic bone disease, and skeletal dysplasia. In these situations, the standard principles of TKA still apply, including restoration of the mechanical alignment and soft tissue balance. The challenge relates to the implications of the distal femoral and proximal tibial bone resection in both the coronal and sagittal planes. The extra-articular deformity must in some way be corrected by the bone resection. There are several options for correction of the deformity; one is arthroplasty with intra-articular correction, or combined with an extra-articular corrective osteotomy, either as a staged or simultaneous procedure.

Keywords

Extra-articular deformity Preoperative templating Medial parapatellar incision Tibial osteotomy Femoral osteotomy 

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Giles R. Scuderi
    • 1
  • Steven B. Haas
    • 2
  • Jonathan L. Berliner
    • 2
  • Michael J. Assayag
    • 3
  • S. Robert Rozbruch
    • 3
    Email author
  • Anton Khlopas
    • 4
  • Grayson P. Connors
    • 5
  • Chukwuweike U. Gwam
    • 5
  • Jaydev B. Mistry
    • 5
  • Ronald E. Delanois
    • 5
  • Michael A. Mont
    • 4
    Email author
  • Bertrand W. Parcells
    • 6
  • Dexter K. Bateman
    • 7
  • Jared S. Preston
    • 8
  • Alfred J. Tria
    • 9
  1. 1.Northwell Health Orthopedic InstituteNew YorkUSA
  2. 2.Adult Reconstruction and Joint Replacement, Hospital for Special SurgeryNew YorkUSA
  3. 3.Limb Lengthening and Complex Reconstruction Service, Department of Orthopaedic SurgeryHospital for Special Surgery, Weill Cornell Medicine, Cornell UniversityNew YorkUSA
  4. 4.Department of OrthopaedicsCleveland ClinicClevelandUSA
  5. 5.Rubin Institute for Advanced Orthopedics, Sinai Hospital of BaltimoreBaltimoreUSA
  6. 6.Department of OrthopedicsRutgers – Robert Wood Johnson University HospitalNew BrunswickUSA
  7. 7.Department of Orthopaedic SurgerySaint Peter’s University HospitalNew BrunswickUSA
  8. 8.Department of OrthopedicsRobert Wood Johnson University HospitalNew BrunswickUSA
  9. 9.Orthopedic Center of New JerseySomersetUSA

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