It was managed by a Posterior stablised knee with medial condylar (not epicondylar) osteotomy, pulled up at 30 degrees flexion to tighten the MCL. I have been lucky. Done well so far 4 years postop. May be a Contrained knee should be kept as a back up in OT
do u follow the technique described by Healey from MGH, Boston in Clin Orthop 1998, where a large bone block is transferred proximally...?
ReplyDeletecould you guide on sequence of lateral release on a valgus knee..??
Valgus in extension with no distal lateral femoral hypoplasia or lateral tibial defect- Simple IT band release from tibia would suffice. After IT band release the valgus in extension should be correctable. posterio lateral pie crusting to correct if needed after bone cuts. The remaining medial collateral laxity in tightened by Medial condyle osteotomy, I repeat and not epicondyle.With trial implants in situ tighten MCL in 30 degrees flexion and fix with K wires and check stability in full ROM. I have not followed any bodys protocol and do not know whether i am doing the same. I have done in about 5 times and two of my colleagues too have done with success. Mind you this is not for valgus but a plastic deformed but intact MCL with an end point. The follow up is only 4 years.
ReplyDeleteKeep a VVC, TC# backup.