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placement (in flexion and posterior translation) to equalize gaps. Reduction osteotomy is a useful manoeuvre to achieve further correction and balance of ligaments. 4) Extra-articular correction may be required on the femoral side or tibial side; it may entail performing a concomitant sliding medial or lateral femoral condylar osteotomy, transverse corrective femoral or tibial osteotomy. Screws, plates or locking IM nails, stems or sleeves may be required to fix the osteotomy. 5) Associated bone defects on the tibial plateau may need to be addressed by autologous grafting or metal augments with additional stems. 6) Most deformities can be treated with a posterior-stabilized device. Additional constraint in the form of a varus-valgus constrained implant may occasionally be deployed if there is residual ligament imbalance or a larger flexion gap; rarely a hinge may be used if there is significant stretching/lack of integrity of the medial collateral ligament or a flexion gap that is too large to be dealt with using a vvc implant. References 1. Mullaji A, Shetty GM. Surgical Technique: Computer-assisted Sliding Medial Condylar Osteotomy to Achieve Gap Balance in Varus Knees During TKA Clin Orthop Relat Res Jan 2013 2. Mullaji A, Shetty GM, Lingaraju AP Computer-assisted total knee replacement in patients with arthritis and a recurvatum deformity J Bone Joint Surg Br 2012; 94-B 5: 642-647 3. Mullaji A, Shetty G. Total knee replacement for arthritic knees with tibio-fibular stress fractures: Classification and treatment guidelines J Arthroplasty 2010; 25(2): 295-301 4. Mullaji A, Shetty GM. Lateral Epicondylar Osteotomy Using Computer Navigation in Total Knee Arthroplasty for Rigid Valgus Deformities J Arthroplasty 2010; 25(1):166-9 5. Mullaji A, Shetty G. Computer-Assisted Total Knee Arthroplasty for Arthritis With Extra-articular Deformity J Arthroplasty 2009; 24 (8): 1164-1169 6. Mullaji AB, Marawar S, Sharma A. Correcting varus deformity. J Arthroplasty 2007; 22(4) 15-19. 7. Mullaji AB, Padmanabhan V, Jindal G. Total Knee Arthroplasty for Profound Varus Deformity: Technique and radiological results in 173 knees with varus more than 20 degrees. J Arthroplasty 2005; 20(5): 550-561. 42
IDEAL POSTOPERATIVE ALIGNMENT FOR TKA ANATOMICAL IS BETTER Hilde Vandenneucker UZ KU Leuven, Belgium 1. Tradition = neutral mechanical alignment /Nowadays trend to anatomic restoration 2. Is neutral = anatomical = natural /normal For an important fraction of normal population (M 32% / F 17%) is natural ≥ 3°varus. Restauration of neutral alignment might be unnatural, with need for release of medial soft tissue, in this population group 3. Is neutral important for long-term survival Growing evidence that mild residual varus is not biomechanical harmful 43
Page 1 and 2: The Osteoarthritic Knee Best Curren
Page 3 and 4: Patellofemoral + medial OA in a 60
Page 5 and 6: SESSION 8 INFECTION Chairmen: S. Ho
Page 7 and 8: LOAD ABSORPTION - A SOLUTION TO DEL
Page 9 and 10: THE ROLE OF HIGH TIBIAL OSTEOTOMY P
Page 11 and 12: PATIENTS EXPECTATIONS AND OUTCOME A
Page 13 and 14: CASE 1 OSTEOARTHRITIS GRAD II MEDIA
Page 15 and 16: CASE 1 GRADE II OA NEUTRAL ALIGNMEN
Page 17 and 18: CASE 2 GRADE II MEDIAL OA IN ACTIVE
Page 19: CASE 3 OSTEOARTHRITIS GRAD III MEDI
Page 22 and 23: CASE 3 GRADE III MEDIAL OA IN ACTIV
Page 24 and 25: CASE 4 GRADE III LATERAL OA IN ACTI
Page 26 and 27: CASE 5 PATELLOFEMORAL + MEDIAL OSTE
Page 28 and 29: CASE 5 PATELLOFEMORAL + MEDIAL OA I
Page 30 and 31: PLANNING + APPROACH Roland Becker D
Page 32 and 33: BONE CUTS +ROTATIONAL POSITION Norb
Page 34 and 35: SOFT TISSUE BALANCING + PATELLAR TR
Page 36 and 37: BLOOD MANAGEMENT + PAIN CONTROL & R
Page 38 and 39: WHO WILL PAY THE COSTS OF NEW TECHN
Page 40 and 41: HOW TO IMPROVE PATELLO-FEMORAL TRAC
Page 44 and 45: PLANNING WITH CONVENTIONAL X-RAY OR
Page 46 and 47: MULTIMODAL APPROACHES FOR A SHORTER
Page 48 and 49: STAYING OUT OF TROUBLE AT PRIMARY T
Page 50 and 51: GAP BALANCING TECHNIQUE AND STABILI
Page 52 and 53: “ADAPTED” MEASURED RESECTION TE
Page 54 and 55: PATELLAR RESURFACING TECHNICAL TIPS
Page 56 and 57: TKA IN POST-TRAUMATIC OSTEOARTHRITI
Page 58 and 59: TKA IN THE STIFF KNEE Michel Bonnin
Page 60 and 61: HOW DO I MANAGE SEVERELY DEFORMED K
Page 62 and 63: which will create easier extension
Page 64 and 65: PLANNING AND CORRECTION OF EXTRA-AR
Page 66 and 67: Fig. 2. Case number 10, a 74-year-o
Page 68 and 69: INFECTION DIAGNOSIS - A EUROPEAN PE
Page 70 and 71: MANAGEMENT EARLY WOUND HEALING COMP
Page 72 and 73: DEBRIDEMENT AND POLYETHYLENE LINER
Page 74 and 75: 4. Barrack RL, Engh G, Rorabeck C,
Page 76 and 77: FAILURE ANALYSIS AND PATIENT SELECT
Page 78 and 79: APPROACH / IMPLANT REMOVAL + 3 STEP
Page 80 and 81: References 1. Meneghini RM, Lewalle
Page 82 and 83: LEVEL OF CONSTRAINT + EXTENSOR MECH
Page 84 and 85: WHICH IS THE BEST STEM EXTENSION FO
Page 86 and 87: WHICH IS THE BEST STEM EXTENSION FO
Page 88 and 89: FILLING THE DEFECT. METAPHYSEAL SOL
Page 90 and 91: THE BEST SPACER FOR THE INFECTED TK
Page 92 and 93:
EXPOSURE FOR REVISION TKA: HOW DO Y
Page 94 and 95:
USE OF HINGES IN REVISION TOTAL KNE
Page 96 and 97:
References 1. Lachiewicz PF. Tantal
Page 98 and 99:
DIAPHYSEAL PREPARATION AND FIXATION
Page 100 and 101:
HOW TO TREAT A DAMAGED PATELLA DURI
Page 102 and 103:
REVISION TKA WITH ASSOCIATED EXTRA-
Page 104:
CASE - BILATERAL INFECTED TKA: EVAL
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