"SMALL TWEAKS MAKE A BIG DIFFERENCE" CORRECTION OF SIGNIFICANT VARUS DEFORMITIES BY UKA.

Kohli P, Waybase H A, Patel P, Allamwar A, Nadkarni S

Abstract


Aim :It has so far been considered challenging  to correct large combined varus & flexion deformities ( more than 12 degrees)with partial knee replacement. Hence UKR despite its many advantages in function & durability, remains restricted in use to a small proportion of osteoarthritic knees.Surgeons opt for the assumedly safer option of TKR which is less function friendly and not suited for Asian lifestyle. Also TKR  involves extensive bone resection including often the uninvolved compartment, significant soft tissue injury & thus prolonged rehabilitation.We aimedto investigate the efficacy of correction of close to 15 degree varus and 10 degree fixed flexion deformity, by a unique combination of osteophytectomy,complete menisectomy and  intraarticular peri tibial capsular release, and keeping bone cuts &removal to the minimum.

Materials & Methods: 25 patients with deformities of more than 12 degrees Varus& fixed flexion deformity were enrolled for the study. All patients had primarily medial compartment affliction with relevant inclusion & exclusion criteria.

Scoring was done by VAS & Oxford knee score.

Results :reduction in VAS from 7-8 to 1-2. Mean Oxford score went up from a mean of 24 to 45 .Average correction was from 12.25 degree Varus deformity (range 8 to 16 degrees ) to 3.96 degrees varus deformity ( range 2.95 to 6 degrees )&7.8 degrees fixed flexion deformity ( range 7 to 14  degree ) to 3 degreesFFD post op.

Results were maintained for next 3 to 6 months. FFD further reduced from average 3 degree to 0 degrees over 6 months.

Conclusion: Our proposed method and protocol can help correct deformities upto 15 degrees in frontal plane and 10 degrees in sagittal plane. The good to excellent results were maintained or improved over the next 6 months.


Keywords


Unicondylar knee replacement, UKR, correction, varus , valgus , menisectomy, capsular release

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