Moyad Thomas F, Estok Daniel
Department of Orthopedics, Brigham and Women's Hospital, Boston, MA, USA.
J Knee Surg. 2009 Jan;22(1):21-6. doi: 10.1055/s-0030-1247722.
Total knee arthroplasty (TKA) performed in knees with mild or moderate intraarticular deformity often can be resolved with careful ligament balancing and bone resection. However, extra-articular deformity may require an osteotomy to safely create rectangular flexion and extension gap balance. In these challenging situations, restoring the mechanical axis through intra-articular bone resection and soft tissue releases alone can lead to excessive bone loss and ligament instability. We report a case of TKA with combined femoral and tibial osteotomies in a post-polio patient with extra-articular deformities. Although a few small case studies have been previously published in the literature, specific details regarding this procedure are lacking. Our objective is to provide a detailed surgical technique and to review the indications for extra-articular osteotomies performed during TKA.
在伴有轻至中度关节内畸形的膝关节中进行全膝关节置换术（TKA），通常通过仔细的韧带平衡和骨切除即可解决。然而，关节外畸形可能需要进行截骨术，以安全地建立矩形的屈伸间隙平衡。在这些具有挑战性的情况下，仅通过关节内骨切除和软组织松解来恢复机械轴可能会导致过多的骨质流失和韧带不稳定。我们报告一例在患有关节外畸形的小儿麻痹后遗症患者中进行股骨和胫骨联合截骨术的TKA病例。尽管此前文献中已发表了一些小型病例研究，但缺乏关于该手术的具体细节。我们的目的是提供详细的手术技术，并回顾TKA期间进行关节外截骨术的适应症。
