tailieunhanh - Triệu chứng đầu gối

Dị tật đòi hỏi phải phẫu thuật đầu gối Valgus là khó khăn để quản lý do sự hiếm tương đối và cơ khí sinh học bất thường của điều kiện và các mô mềm và xương bệnh lý tính năng độc đáo. Lựa chọn phẫu thuật bao gồm mở ổ arthroscopic, arthroplasty mài mòn, chày osteotomy gần vẹo | Symptomatic Valgus Knee The Surgical Options Paul B. Murray MD and James A. Rand MD Abstract Valgus knee deformities requiring surgery are difficult to manage due to the relative rarity and abnormal biomechanics of the condition and the unique soft-tissue and osseous pathologic features. Surgical options include arthroscopic debridement abrasion arthroplasty proximal tibial varus osteotomy distal femoral varus osteotomy combined femoral-tibial varus osteotomy unicompartmental knee arthroplasty and total knee arthroplasty. Each procedure has its own indications contraindications and limitations. J Am Acad Orthop Surg 1993 1 1-9 Severe valgus deformity can result from many different causes including metabolic conditions inflammatory arthritis posttraumatic and primary osteoarthritis and an excessively overcorrected proximal tibial valgus osteotomy. Fortunately severe valgus deformity is uncommon. Since prevalence studies of gonarthrosis have not differentiated between medial and lateral disease the actual incidence of valgus deformity is unknown. However many reports have shown that valgus knee is much less common than varus knee. Valgus deformities are more common in women than in men and are more prevalent in certain conditions such as rheumatoid arthritis rickets renal osteodystrophy and infantile poliomyelitis. The pathologic features in the valgus knee are distinctive. The soft-tissue structures on the lateral and posterolateral concave side of the joint are contracted. The involved structures may include the iliotibial band the popliteus tendon the lateral collateral ligament the posterolateral capsule the lateral head of the gastrocnemius the lateral intermuscular septum and the long head of the biceps femoris. At the same time the medial collateral ligament and the medial capsular structures may Vol. 1 No. 1 Sept. Oct. 1993 be attenuated. Unlike varus knee deformity most of the osseous abnormality in the valgus knee occurs on the femoral side particularly in