2015 ISAKOS Biennial Congress ePoster #1453

Efficacy and Safety of a Novel Three-Step Medial Release Technique in Varus Total Knee Arthroplasty

Yong In, MD, PhD, Seoul KOREA, REPUBLIC OF
Min Woo Kim, MD, Seoul, Seo-cho gu KOREA, REPUBLIC OF
In-Jun Koh, MD, PhD, Prof., Seoul KOREA, REPUBLIC OF
Ju Hwan Kim, MD, Seoul KOREA, REPUBLIC OF
Man-Soo Kim, MD, Seoul KOREA, REPUBLIC OF
Sung Won Jang, MD, Seoul, Seoul KOREA, REPUBLIC OF

Department of orthopedics, Seoul St' Mary's Hospital , Seoul, Seo-cho Gu, KOREA

FDA Status Not Applicable

Summary: Our concise 3 step algorithmic medial release technique was safe and efficacious in varus TKA.

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Abstract:

Background

There exists a controversy in medial release sequence and techniques in varus total knee arthroplasty (TKA). Some algorithms consist of too many steps and some protocols are too much extensive.
Purposes: To evaluate the safety and efficacy of our 3 step algorithmic medial release technique in varus TKA by comparing mediolateral stability between groups over time.

Methods

Three hundred seventeen consecutive varus TKAs were performed applying the 3 step algorithmic medial release technique which consisted of sequential release of 1) deep medial collateral ligament (dMCL), 2) semimembranosus, and 3) superficial medial collateral ligament (sMCL). Mediolateral stability of the knee was compared between groups according to the medial release steps at 3 months, 6 months and 12 months postoperatively using the stress radiographs.

Results

One hundred seventeen knees were balanced after step 1 release (group 1). One hundred fourteen knees were balanced after step 1 and 2 release (group 2). Thirty six knees needed steps 1 to 3 release to obtain gap balance (group 3). There were significant differences in preoperative knee alignments between groups (group1; varus 3.4° ± 3.0°, group 2; varus 5.2° ± 4.1°, group 3; varus 7.6° ± 5.7°, P <0.001). Group 3 showed significant lateral laxity than group 1 and 2 at 3 and 6 months postoperatively (P = 0.016, P = 0.006, respectively). However, there was no difference in lateral laxity between groups at 12 months after operation. There were no differences in medial laxity between groups at 3, 6, and 12 months postoperatively.

Conclusions

Our concise 3 step algorithmic medial release technique was safe and efficacious in varus TKA.
Keywords Total knee arthroplasty, varus deformity, soft tissue release, deep medial collateral ligament, semimembranosus, superficial medial collateral ligament