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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2011 June;62(3):157-63
Medial pivot prosthesis in valgus knee
Martucci E., Bracci G., Gozzi E., Trisolino G., Trentani F.
Chirurgia Ricostruttiva dell’Anca e del Ginocchio, Istituto Ortopedico Rizzoli, Bologna, Italia
AIM: Total knee arthroplasty (TKA) in valgus knee is more difficult than in well aligned or varus knee, The correction of deformities and ligament balancing are the priority . The aim of this study was to evaluate our experience on 20 knees treated with Advance TKA.
METHODS: The study group is based on 20 consecutive patients who underwent primary TKA using cemented prosthesis fixation and a medial pivot implant. Study participants included 14 women and 6 men with a mean age of 69.6 years (range, 60 to 82 years). Osteoarthritis (80%) was the most common diagnosis rheumatoid arthritis (16%), and other findings (4%). All patients received the Advance TKA (cruciate ligament sacrificing) prosthesis (Wright) using cemented fixation.
RESULTS: Twelve knees were rated excellent, 8 as good. The femorotibial mechanical axis was corrected from a valgus of 15° to 5° in postoperative. There was no varus-valgus instability in 18 knees, and 2 knees had approximately 5° varus-valgus instability in extension. There was palpable, non-painful, patellofemoral crepitus noted in one knee.
CONCLUSION: The Advance TKA (with cruciate ligament sacrificing) prosthesis (Wright) with cemented fixation was successful in primary arthroplasty in valgus knees, also in severe deformities with incompetent medial collateral ligament.