Correcting extra-articular deformity of the knee: acting in tandem

Morphometric analysis of upper end of tibia

INTRODUCTION

The present study aims to assess different morphometric parameters of condylar and intercondylar surface of tibia and to compile the results, analyze and formulate a baseline data for future studies with relevance to Indian population and also to compare the current data with accessible literature for pertinent surgical utilities. Morphometric parameters of upper end of tibia can be used to guide treatment and monitor outcome of total knee replacement surgeries. Information regarding morphometry of upper end of the tibia is vital as it provides reliable method of assessing knee deformity.

MATERIALS AND METHODS

The study group comprised of 50 male and 50 female adult human tibiae. Morphometric measurements of medial condyle, lateral condyle and intercondylar area of tibiae were meticulously recorded with digital Vernier calipers with a least count of 0.01 mm. Student's t-test was used with significant level of p-value < 0.05 and 95% confidence interval.

RESULTS

All measurements were found to be statistically significant when compared between the two sexes on both sides (p-value<0.05). Anteroposterior measurements were found to be greater than transverse measurements for both medial and lateral condyles. Furthermore, both anteroposterior and transverse measurements were greater in medial condyle than in lateral condyle on both sides and sexes.

CONCLUSION

The present study is an endeavor to provide a base line data pertaining to morphometric details of upper end of tibia with reference to unicompartmental and total knee arthroplasty in Indian population. The results of the study assume special importance in view of the technical advancements in reconstructive surgical procedures in orthopedic practice.

Computer-assisted total knee arthroplasty for arthritis with extra-articular deformity

Forty extra-articular deformities (22 femoral and 18 tibial) in 34 patients (mean age, 63.1 years) were studied. Mean coronal extra-articular deformity was 9.3 degrees ; mean preoperative limb alignment was 166.7 degrees . Three limbs underwent simultaneous corrective osteotomy; the rest were treated with intra-articular correction during computer-assisted total knee arthroplasty (TKA). Mean postoperative limb alignment was 179.1 degrees . At a mean follow-up of 26.4 months, the Knee Society knee score improved from a mean preoperative score of 49.7 to 90.4 points postoperatively; function score improved from 47.3 to 84.9 points. Computer-assisted TKA is a useful alternative to conventional TKA for knee arthritis with extra-articular deformity where accurate restoration of limb alignment may be challenging because of the presence of a deformed tibia or femur or in the presence of hardware.