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. 2009 Dec;33(6):1577-83.
doi: 10.1007/s00264-008-0698-5. Epub 2008 Dec 9.

Total knee replacement in the fixed valgus deformity using a lateral approach: role of the automatic iliotibial band release for a successful balancing

P Boyer  1 , D Boublil, B Magrino, P Massin, D Huten; Guepar Group
Affiliations

Total knee replacement in the fixed valgus deformity using a lateral approach: role of the automatic iliotibial band release for a successful balancing

P Boyer et al. Int Orthop. 2009 Dec.

Abstract
in English, French

The purpose of this work was to document eleven years of experience in knee replacement for fixed knee valgus through a lateral approach with special emphasis on the balancing procedures. At a mean follow-up of seven years, only one revision for sepsis was required in this series of 63 knee replacements. The mean knee score improved from 37 (range 20-45) to 91 (range 65-100) at the last review (p < 0.01) while the function score increased from 29.5 (range 0-50) to 78.7 (range 10-100) (p = 0.01). The mean mechanical axis (HKA) was 14.7 degrees of valgus preoperatively and 1 degrees of valgus postoperatively. After the iliotibial band was automatically released in the approach, only four of 63 knees required additional release for tightness in extension. These results underline the appeal of the lateral approach with the automatic release of the iliotibial band. If required, additional ligament release is recommended step-by-step after bone section to avoid postoperative instability.

Le but de cette étude était de rapporter onze années d’expérience de la voie d’abord latérale du genou pour implantation d’une prothèse totale pour genu valgum fixé. Une attention particulière a été portée sur les techniques d’équilibrage ligamentaire. Au recul moyen de 7 ans, une seule reprise chirurgicale dans notre série de 63 prothèses avait été nécessaire en raison d’une infection. Le score moyen du genou était de 37 (20 à 45) en post-opératoire et de 91 (65 à 100) au dernier recul (p < 0.01) alors que le score fonctionnel passait de 29.5 (0 à50) à 78.7 (10 à 100) (p = 0.01). L’axe mécanique HKA était de 14.7° de valgus en préopératoire et de 1° de valgus en post-opératoire. Après libération de la bandelette ilio-tibiale, seulement 4 sur 63 des genoux nécessitaient des gestes de libérations supplémentaires pour raideur en extension.

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Figures

Fig. 1
Fig. 1
Division and elevation from Gerdy’s tubercle of the iliotibial band, taken in continuity with the anterior compartment fascia and dissection of the fat pad
Fig. 2
Fig. 2
a Closing of the iliotibial band (ITB) division with exposure of the joint at the bottom of the incision. b Total coverage of the joint using the fat pad flap
See this image and copyright information in PMC

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