tailieunhanh - Phẫu thuật đầu gối

Đầu gối valgus trình bày một bộ duy nhất của các vấn đề phải được giải quyết trong tổng arthroplasty đầu gối. Cả hai xương và mô mềm dị tật phức tạp phục hồi của sự liên kết thích hợp, vị trí của các thành phần, và đạt được sự ổn định chung. Các biến có thể cần phải được giải quyết bao gồm condyle xương đùi | Total Knee Arthroplasty in the Valgus Knee Paul J. Favorito MD William M. Mihalko MD PhD and Kenneth A. Krackow MD Abstract The valgus knee presents a unique set of problems that must be addressed during total knee arthroplasty. Both bone and soft-tissue deformities complicate restoration of proper alignment positioning of components and attainment of joint stability. The variables that may need to be addressed include lateral femoral condyle or tibial plateau deficiencies secondary to developmental abnormalities and or wear primary or acquired contracture of the lateral capsular and ligamentous structures and occasionally laxity of the medial collateral ligament. Understanding the specific pathologic anatomy associated with the valgus knee is a prerequisite to selecting the proper surgical method to optimize component position and restore soft-tissue balance. J Am Acad Orthop Surg 2002 10 16-24 Most surgeons agree that the arthritic knee with valgus deformity presents a unique set of problems that must be addressed at the time of total knee arthroplasty TKA . Correction of the deformity and restoration of anatomic alignment should be achieved to maximize the longevity of the replaced components. Although several authors have suggested TKA as a potential treatment for the knee with severe valgus deformity 1-9 none has comprehensively reviewed the extensive kinematic and anatomic variables that need to be understood in attempting to balance the TKA in a patient with a valgus deformity. The valgus knee may have any combination of primary or secondary bone and soft-tissue abnormalities. These include contracted lateral capsular and ligamentous structures lax medial structures and acquired or preexisting bony anatomic deficiencies. This constellation of pathology makes attaining soft-tissue balance when the knee is returned to physiologic alignment extremely difficult. The recent liter-ature10 11 has underscored the importance of ligament balancing and of assessing .