Medial closing wedge distal femoral osteotomy in ’Rescue Realignment’ post primary total knee arthroplasty: A mini-case-series of three cases

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2025-05-23 DOI:10.1016/j.knee.2025.05.002

Ahmed Mabrouk , Lucy Bell , Matthew Dawson

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引用次数: 0

Abstract

Background

Medial closing wedge distal femoral osteotomy (MCWDFO) is an effective procedure mainly indicated for correction of the valgus malaligned native knee. Nevertheless, valgus malalignment has been reported following total knee arthroplasty (TKA). Therefore, employing a realignment osteotomy for a symptomatic valgus malaligned TKA could be a potential rescue from an unnecessary revision surgery with high morbidity and mortality and uncertain outcome.

Methods

The following report describes 3 consecutive cases presented with symptomatic valgus malalignment following primary TKA. The 3 cases were treated with MCWDFO to improve the overall limb alignment and biomechanics. Preoperative and postoperative alignment indices were recorded from long leg standing radiographs (LSRs). Patient reported outcome measures, assessed by simple knee value (SKV) scores, visual analogue scale (VAS) for pain and patient satisfaction were reported preoperatively and postoperatively at the latest follow up.

Results

Postoperatively, the overall limb alignment has been corrected as represented by the mechanical tibiofemoral angle and Mikulicz line. No intraoperative or postoperative complications were reported. At the final follow up (8 years for two cases and 2 years for one case), significant improvements in patient reported outcome measures, as assessed by the simple knee value and VAS pain scores and 100% satisfaction, were observed.

Conclusion

Medial closing wedge distal femoral osteotomy can be employed in rescue realignment of valgus malalignment post primary TKA with resultant significant improvement in patient reported outcome measures, and 100% satisfaction with no complications in a small series.

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首次全膝关节置换术后“抢救调整”的股骨远端内侧闭合楔形截骨术：三例小型病例系列

内侧闭合楔形股骨远端截骨术（MCWDFO）是一种有效的手术，主要用于矫正外翻不正的膝关节。然而，在全膝关节置换术（TKA）后，外翻错位也有报道。因此，对于有症状的外翻错位TKA，采用复位截骨术可能是一种潜在的治疗方法，可以避免不必要的翻修手术，这种手术的发病率和死亡率都很高，而且结果不确定。方法连续报道3例原发性TKA术后出现症状性外翻错位的病例。3例患者均行MCWDFO治疗，以改善整体肢体直线和生物力学。术前和术后通过长腿站立x线片（lsr）记录对齐指数。患者报告的结果测量，通过简单膝关节值（SKV）评分，视觉模拟疼痛量表（VAS）和患者满意度在术前和术后最新随访时进行评估。结果术后肢体整体对中均以机械胫股角和Mikulicz线矫正。术中及术后无并发症。在最后的随访中（2例为8年，1例为2年），观察到患者报告的结果测量有显著改善，通过简单膝关节值和VAS疼痛评分评估，满意度为100%。结论内侧闭合楔形股骨远端截骨术可用于原发性TKA后外翻错位的抢救性矫正，患者报告的结果明显改善，满意率100%，无并发症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.