Knee最新文献

{"title":"Knee injury and osteoarthritis outcome score and knee society score for the minimal clinically important differences after cruciate-retaining total knee arthroplasty: Two-year follow up","authors":"Takaya Watabe ,&nbsp;Takuya Sengoku ,&nbsp;Masafumi Kubota ,&nbsp;Goro Sakurai ,&nbsp;Shinya Yoshida ,&nbsp;Yuta Taniguchi","doi":"10.1016/j.knee.2024.12.015","DOIUrl":"10.1016/j.knee.2024.12.015","url":null,"abstract":"<div><h3>Background</h3><div>This study investigated changes in the Knee Injury and Osteoarthritis Outcome Score (KOOS), 2011 Knee Society Score (KSS), and minimal clinically important differences (MCIDs) of these scores preoperatively to 2 years after total knee arthroplasty (TKA).</div></div><div><h3>Methods</h3><div>This single-center retrospective study included 168 patients who underwent primary cruciate-retaining (CR) TKA using the subvastus approach. The KOOS and KSS were assessed preoperatively and during the 3-month, 6-month, 1-year, and 2-year follow ups. The MCIDs of the KOOS and KSS were calculated using distribution-based methods with standard deviation.</div></div><div><h3>Results</h3><div>All patient-reported outcome measures improved considerably from preoperatively to 3 months postoperatively. KOOS pain and symptom scores considerably improved at approximately 2 years postoperatively, with KOOS activities of daily living (ADL) and sports/recreation subscale scores showing rapid improvement within 3 months, followed by smaller gains. MCID thresholds for KOOS subscales were as follows: pain, 14.3–15.3; symptoms, 14.1–15.6; ADL, 15.2–16.0; sport/recreation, 11.7–11.8; and quality of life, 13.6–14.4. KSS objective knee indicators and satisfaction improved considerably approximately 2 years postoperatively; however, scores on the expectation and functional activity subscales did not improve after 1 year. MCID thresholds for KSS subscales were as follows: objective knee indicators, 4.6–4.7; satisfaction, 4.9–5.0; expectation, 2.4; and functional activities, 12.0–12.3.</div></div><div><h3>Conclusions</h3><div>Improvements in the KSS objective knee indicators and KOOS subjective pain and symptom scores were similar over the 2-year follow up. These findings may help better understand the expected outcomes of CR-type TKA, especially in severe osteoarthritis cases, thereby informing patient counseling.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"53 ","pages":"Pages 176-182"},"PeriodicalIF":1.6,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of implant design consistency in staged bilateral total knee arthroplasty on gait patterns and functional outcomes: A comparative analysis","authors":"Olgun Bingol ,&nbsp;Taner Karlidag ,&nbsp;Enejd Veizi ,&nbsp;Burak Kulakoglu ,&nbsp;Guzelali Ozdemir ,&nbsp;Ahmet Firat ,&nbsp;Bulent Ozkurt","doi":"10.1016/j.knee.2024.12.011","DOIUrl":"10.1016/j.knee.2024.12.011","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this study was to assess whether there are any differences in plantar pressure distribution and gait cycle between patients with the same implant design and patients with different designs in staged bilateral TKA and to examine the impact of these differences on clinical and functional outcomes.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted of all patients who underwent staged bilateral TKA. The patients were divided into two groups based on the prosthesis design used in both knees. A comparison was made between the two groups regarding various factors, including demographic data, radiological measurements, functional scores, gait analysis, and plantar pressure mapping.</div></div><div><h3>Results</h3><div>Patients with the same implant design were found to have statistically significantly higher functional scores (p = 0.001). Furthermore, the difference in pre-swing phase plantar distribution for both extremities in patients with different implant designs was found to be greater than in those with the same implant design (p = 0.031). Similarly, the difference in initial contact phase load distribution between the different implant design groups was found to be significantly higher than that observed in the same implant design group (p = 0.014).</div></div><div><h3>Conclusion</h3><div>In conclusion, individuals with two different implant designs in staged bilateral TKA showed a substantial imbalance in gait cycle and plantar pressure distribution. This may result in various consequences, including impairment in movement, patient dissatisfaction, and even early implant failure. Therefore, the same implant design should be used as much as possible to achieve balanced knee kinematics and favorable outcomes.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"53 ","pages":"Pages 168-175"},"PeriodicalIF":1.6,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior cruciate ligament injuries managed with internal bracing","authors":"Ashley Arakkal,&nbsp;Waldo Scheepers,&nbsp;Michael Held","doi":"10.1016/j.knee.2024.11.019","DOIUrl":"10.1016/j.knee.2024.11.019","url":null,"abstract":"<div><h3>Background</h3><div>Synthetic augmentation in the form of an internal brace is increasingly used to stabilize injured knee ligaments. This study aimed to evaluate the clinical and radiological outcome of patients with knee dislocations treated with a posterior cruciate ligament (PCL) internal brace.</div></div><div><h3>Methods</h3><div>Synthetic suture tape drilled into the femoral and tibial PCL footprints was performed in patients with multiple knee ligament injuries. PCL tears were either repaired or left in situ if not repairable. Patients with chronic injuries, contraindications to magnetic resonance imaging (MRI) scans, or cognitive impairment were excluded. Patient-reported outcome measures (PROMs), range of motion, stress X-Rays, and MRI scans were assessed. An acceptable outcome was defined as a Lysholm score of 84 or more, grade II laxity or less on stress radiographs and a range of motion from full extension to 90° or more of flexion.</div></div><div><h3>Results</h3><div>Eight patients were included with a median age of 38 years, five were female. No patients had knee flexion less than 90° or an extension deficit of more than 10°. PROMs showed a median Lysholm score of 87. Stress radiographs showed less than 7 mm (Grade I) of posterior translation laxity in all patients. In six patients a follow up MRI scan was obtained, which revealed no healing of the PCL in one patient and only partial healing in three patients.</div></div><div><h3>Conclusion</h3><div>All patients had stable knees and acceptable PROMs, despite tunnel widening or reaction to synthetic material on MRI in five of the six patients. Factors such as anisometric tunnel position and the absence of PCL tear repair may have contributed to the tunnel widening.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 255-262"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The pathoanatomy of medial ligamentous disruption in the dislocated and multiple ligament injured knee","authors":"Nancy Park ,&nbsp;Jay Moran ,&nbsp;Logan Petit ,&nbsp;Joseph Kahan ,&nbsp;William McLaughlin ,&nbsp;Peter Joo ,&nbsp;Michael Lee ,&nbsp;Joshua Green ,&nbsp;Kinjal Vasavada ,&nbsp;Isabel Chalem ,&nbsp;Peter Jokl ,&nbsp;Michael J. Alaia ,&nbsp;Michael J. Medvecky","doi":"10.1016/j.knee.2024.11.002","DOIUrl":"10.1016/j.knee.2024.11.002","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe the medial-sided pathoanatomy and ligament injuries in acute MLKIs with medial-sided involvement and<!--> <!-->look for<!--> <!-->associated injury patterns based upon location of ligamentous injury.</div></div><div><h3>Methods</h3><div>Patients who underwent treatment for MLKI at two level-1 trauma centers were identified between January 2001 and May 2023. Only cases involving<!--> <!-->complete disruption of the superficial medial collateral ligament (sMCL) were included. Zone of injury to the sMCL, the posterior oblique ligament (POL), the medial patellofemoral ligament (MPFL), the vastus medialis oblique (VMO) was recorded, as well as demographics,<!--> <!-->injury details, neurovascular status, and mechanism of injury.<!--> <!-->Data was summarized using<!--> <!-->descriptive statistics.</div></div><div><h3>Results</h3><div>A total of 92 patients<!--> <!-->were included, with a mean age of 37.8 ± 12.7 years. Forty-four (47.8%) patients had a high velocity injury. Within sMCL tears, 39% were proximal avulsions, 29% were midsubstance tears, and 32% were distal avulsions. The medial-sided injury patterns were: 31 (33.7%) isolated sMCL tears, 24 (27.3%) combined sMCL, POL, and MPFL tears, 23 (25%) combined sMCL and MPFL tears, and 11 (12%) combined sMCL and POL tears. Most common location of sMCL injury varied based upon the number of associated medial knee ligaments injured: isolated sMCL (even distribution), sMCL &amp; POL (distal), sMCL-MPFL (proximal), sMCL-POL-MPFL (proximal).</div></div><div><h3>Conclusion</h3><div>Medial-sided ligament injuries seen MLKIs were found to occur in four injury patterns ranging from isolated sMCL or combined injury patterns of the adjacent medial structures. Additionally, location of sMCL injury varied based upon the number of medial-sided ligaments injured.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 246-254"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior capsular release around the intercondylar notch increases extension gap without affecting flexion gap in posterior-stabilized total knee arthroplasty","authors":"Yutaka Suetomi ,&nbsp;Patricio Ⅲ Espinoza Dumlao ,&nbsp;Atsunori Tokushige ,&nbsp;Venkata Vinay Atluri ,&nbsp;Takashi Sakai ,&nbsp;Hiroshi Fujii","doi":"10.1016/j.knee.2024.11.014","DOIUrl":"10.1016/j.knee.2024.11.014","url":null,"abstract":"<div><h3>Background</h3><div>In posterior-stabilized (PS) total knee arthroplasty (TKA), joint extension gap decreases after placement of a femoral trial component which causes imbalance between the extension and flexion gaps. Previous studies have demonstrated that capsular release around the intercondylar notch can enlarge the extension gap; however, its impact on the flexion gap is unknown. This study assessed the effect of capsular release around the intercondylar notch on both extension and flexion gaps.</div></div><div><h3>Methods</h3><div>This study included 100 patients who underwent PS-TKA, and capsular release was performed intraoperatively to avoid flexion contracture and to balance the extension–flexion gap. We measured the gap and tilting angle with a femoral trial using FuZion™ tensor, applying a joint distraction force of 40 lbs. The differences in gap and tilting angle were assessed before and after capsular release.</div></div><div><h3>Results</h3><div>The mean center component gap (CG) before and after capsular release was 10.0 mm and 12.5 mm in extension (<em>P</em> &lt; 0.001), 14.1 mm and 14.2 mm in flexion (<em>P</em> = 0.58), respectively. Calculated medial CG before and after capsular release was 9.2 mm and 11.4 mm in extension (<em>P</em> &lt; 0.001), 12.6 mm and 12.7 mm in flexion (<em>P</em> = 0.20), respectively. The average medial CG difference significantly decreased from 3.4 mm to 1.3 mm after release.</div></div><div><h3>Conclusion</h3><div>This study confirmed that capsular release around the intercondylar notch significantly enlarges the extension component gap, while having an insignificant effect on the flexion component gap in PS-TKA.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages 238-245"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is the evidence? Who can you trust?","authors":"Caroline Hing,&nbsp;Oday Al-Dadah","doi":"10.1016/j.knee.2024.12.012","DOIUrl":"10.1016/j.knee.2024.12.012","url":null,"abstract":"","PeriodicalId":56110,"journal":{"name":"Knee","volume":"52 ","pages":"Pages A1-A3"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of surgical treatment on relative tibial external rotation in patients with recurrent patellar dislocation","authors":"Kangning Tang ,&nbsp;Xianming Wang ,&nbsp;Yan Jin ,&nbsp;Tao Zhang ,&nbsp;Qing Wang","doi":"10.1016/j.knee.2024.12.006","DOIUrl":"10.1016/j.knee.2024.12.006","url":null,"abstract":"<div><h3>Background</h3><div>In the knee joints of patients with recurrent patellar dislocation (RPD), an increased relative tibial external rotation (rTER) is often observed. However, the changes in this parameter pre- and postoperatively remain unclear.</div></div><div><h3>Purpose</h3><div>The purpose of this study was to reveal preoperative and postoperative changes in rTER in patients with RPD.</div></div><div><h3>Methods</h3><div>A total of 48 cases with RPD in the knee joint were included in the study group, while 50 cases with normal knee joints were included in the control group. The measured parameters included tibial tubercle–trochlear groove distance (TT-TG) and rTER. Measurements were recorded for RPD patients both pre-and postoperatively. Analysis of variance was used to assess the intergroup differences in TT-TG and rTER, and a <em>t</em>-test was employed to evaluate differences among various surgical procedures.</div></div><div><h3>Results</h3><div>In the RPD group, rTER was significantly higher than in the control group (<em>P</em>＜0.001), with no statistically significant difference in postoperative rTER (<em>P</em> = 0.366). There was no significant difference in postoperative rTER between the RPD group and the control group (<em>P</em> = 0.057). The difference in TT-TG distance before and after operation in RPD patients was statistically significant (<em>P</em> &lt; 0.001). Within the subgroups, there was a significant difference in rTER between pre − and post-operation in the tibial tuberosity osteotomy combined with medial patellofemoral ligament reconstruction (MPFLR) group (<em>P</em> = 0.043). Multivariate analysis showed that age and body mass index had no correlation with rTER.</div></div><div><h3>Conclusions</h3><div>Compared with MPFLR alone, tibial tuberosity osteotomy combined with MPFLR can significantly reduce postoperative rTER and make rTER tend to be normal. For patients with elevated TT-TG and abnormal rTER, tibial tuberosity osteotomy combined with MPFLR may be a better choice.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"53 ","pages":"Pages 147-153"},"PeriodicalIF":1.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using three-zone flexible cones at the metaphyseal–diaphyseal junction may avoid the need for distal femoral replacement: The floating cone technique","authors":"Marc Ferrer-Banús,&nbsp;Montserrat Monfort-Mira,&nbsp;Marta Sabater-Martos,&nbsp;Laia Boadas-Gironès,&nbsp;Clara Chimeno-Pigrau,&nbsp;Juan Carlos Martínez-Pastor","doi":"10.1016/j.knee.2024.12.004","DOIUrl":"10.1016/j.knee.2024.12.004","url":null,"abstract":"<div><div>Distal femoral replacement (DFR) with megaprostheses is a salvage revision total knee arthroplasty (rTKA) procedure indicated in cases with massive bone defects in the distal femur. As long as these implants achieve fixation only in the diaphysis, the high aseptic loosening rate reported in some series is probably related to a lack of rotational stability. Two patients with extensive distal femoral bone defects with preservation of the metaphyseal–diaphyseal junction underwent rTKA. Instead of performing a DFR with megaprostheses, partially impacted three-zone cones and standard cemented hinged implants were used with the aim of achieving better rotational stability. Both patients showed good evolution after a 12-month follow up. Clinical findings included a normal range of motion (0–100°) without any instability and preserved ability for full weight-bearing ambulation. No signs of prosthetic loosening appeared in the X-rays during follow up. To our knowledge, this was the first time a single partially anchored three-zone cone was used in massive metaphyseal femoral defects. It is an implant-dependent technique that additionally requires the preservation of the metaphyseal–diaphyseal junction, but may avoid the use of megaprostheses in some cases.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"53 ","pages":"Pages 154-159"},"PeriodicalIF":1.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An isolated extra-articular procedure can be indicated for patients with minor instabilities and intact graft after anterior cruciate ligament reconstruction","authors":"Camilo Partezani Helito ,&nbsp;Andre Giardino Moreira da Silva ,&nbsp;Matt Daggett ,&nbsp;Sergio Marinho de Gusmão Canuto ,&nbsp;Carlo Leekninh Paione ,&nbsp;Hernan Galan ,&nbsp;Riccardo Cristiani","doi":"10.1016/j.knee.2024.12.007","DOIUrl":"10.1016/j.knee.2024.12.007","url":null,"abstract":"<div><h3>Background</h3><div>Some patients submitted to isolated ACL reconstruction may have symptomatic postoperative rotational instability. The objective of this study was to evaluate a population with mild rotatory instability after ACL reconstruction, which was submitted to an isolated extra-articular procedure.</div></div><div><h3>Methods</h3><div>Patients submitted to an isolated extra-articular procedure after ACL reconstruction were retrospectively evaluated. Only patients presenting anterior knee instability of less than 5 mm, pivot-shift of a maximum of 1+, and ACL graft intact were included. Demographic data, physical examination and subjective functional scales were evaluated.</div></div><div><h3>Results</h3><div>Twenty patients were included. The mean age was 27.0 ± 7.3 years. The follow up time after the extra-articular procedure was 27.5 ± 6.2 months. The KT-1000 decreased from 3.0 mm ± 0.7 mm to 2 mm ± 0.4 mm (<em>P</em> = 0.00016). The pivot-shift improved from 100% of grade 1 positivity to 30% (6/20 patients) of grade 1 positivity (<em>P</em> &lt; 0.0001). The IKDC showed no difference (74.4 ± 11.8 vs. 87.6 ± 5.8; <em>P</em> = 0.087), but the percentage of patients who passed the PASS IKDC cut-off value increased from 45% (9/20) to 95% (19/20) (<em>P</em> = 0.0012). The Lysholm increased from 81.1 ± 7.3 to 91.2 ± 5.7 (<em>P</em> = 0.0001).</div></div><div><h3>Conclusions</h3><div>Patients submitted to an isolated extra-articular procedure due to residual instability after ACL reconstruction showed improvement in physical examination (KT-1000 and pivot-shift) and subjective functional scales. This procedure can be considered for a specific population with minor instabilities and intact ACL graft, avoiding a complete ACL revision.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"53 ","pages":"Pages 160-167"},"PeriodicalIF":1.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction of severe varus deformity in total knee arthroplasty with the technique of tibial plateau reduction","authors":"Guo-Chun Zha,&nbsp;Gang Bao,&nbsp;Hao Wu,&nbsp;He-Ping Wang,&nbsp;An-Dong Wang,&nbsp;Zhi-Jun Shen","doi":"10.1016/j.knee.2024.12.005","DOIUrl":"10.1016/j.knee.2024.12.005","url":null,"abstract":"<div><h3>Background</h3><div>The optimal soft tissue release technique for severe varus total knee arthroplasty (TKA) remains controversial. The technique of tibial plateau reduction was suggested for severe varus deformity during TKA. The purpose of this study was to evaluate the clinical and radiological outcomes of the technique of tibial plateau reduction.</div></div><div><h3>Methods</h3><div>Fifty-one knees (39 patients) with a mechanical femoro-tibial angle (MFTA) greater than 15° treated with TKA was presented. The clinical and radiographic data were gathered prospectively. The patients were divided into two groups according to the preoperative angle: Group A comprised patients with a preoperative MFTA less than or equal to 20°, while Group B included patients with a preoperative MFTA greater than 20°.</div></div><div><h3>Results</h3><div>Among the 51 knees, 46 knees (90.2%) had femoro-tibial component size mismatch. The KSS-KS improved from preoperative 39.9 ± 11.3 points (range:18–68 points) to 92.3 ± 5.2 points (range: 83–100 points) at the final follow up (t = 30.141, <em>P</em> &lt; 0.001); the KSS-FS improved from preoperative 48.0 ± 11.5 points (range: 31–71 points) to 87.2 ± 8.7 points (range: 63–100 points) at the final follow up (t = 19.413, <em>P</em> &lt; 0.001). The mean MFTA was corrected from 21.0 ± 4.7° preoperatively to 2.9 ± 1.8° at the latest follow up (<em>P</em> &lt; 0.001). The preoperative MFTA was less than or equal to 20° in 27 knees (Group A), and greater than 20° in 24 knees (Group B). The mean postoperative MFTA was 1.9 ± 0.9° in Group A, and 4.1 ± 1.7° in Group B (<em>P</em> &lt; 0.001). The neutral limb alignment was reached in 26 knees (96.3%) in group A, which was significantly higher than that in group B (29.7%) (<em>P</em> = 0.019).</div></div><div><h3>Conclusions</h3><div>The technique of tibial plateau reduction provided satisfactory clinical and radiological outcomes without instability for severe varus TKA. However, surgeons should remain aware that the greater the preoperative varus deformity, the greater the postoperative residual varus deformity, and that there is a high incidence of femoro-tibial component size mismatch using the technique.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"53 ","pages":"Pages 138-146"},"PeriodicalIF":1.6,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}