Comparison of Complete Distal Release of  the Medial Collateral Ligament and Medial  Epicondylar Osteotomy during Ligament Balancing in Varus Knee Total Knee Arthroplasty.

Sim JA, Lee YS, Kwak JH, Yang SH, Kim KH, Lee BK. Comparison of complete
distal release of the medial collateral ligament and medial epicondylar osteotomy
during ligament balancing in varus knee total knee arthroplasty. Clin Orthop
Surg. 2013 Dec;5(4):287-91.

Abstract

Background

During ligament balancing for severe medial contracture in varus knee total knee arthroplasty (TKA), complete distal release of the medial collateral ligament (MCL) or a medial epicondylar osteotomy can be necessary if a large amount of correction is needed.

Methods

This study retrospectively reviewed 9 cases of complete distal release of the MCL and 11 cases of medial epicondylar osteotomy which were used to correct severe medial contracture. The mean follow-up periods were 46.5 months (range, 36 to 78 months) and 39.8 months (range, 32 to 65 months), respectively.

Results

There were no significant differences in the clinical results between the two groups. However, the valgus stress radiograph revealed significant differences in medial instability. In complete distal release of the MCL, some stability was obtained by repair and bracing but the medial instability could not be removed completely.

Conclusions

Medial epicondylar osteotomy for a varus deformity in TKA could provide constant medial stability and be a useful ligament balancing technique.

Keywords: Varus knee, Total knee arthroplasty, Medial epicondylar osteotomy.

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