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Review
. 2023 May 30:12:138.
doi: 10.4103/abr.abr_239_21. eCollection 2023.

Pie-Crusting Technique of Medial Collateral Ligament for Total Knee Arthroplasty in Varus Deformity: A Systematic Review

Mehdi Motififard  1 , Hadi Ravanbod  2 , Rashed Rahmati  3 , Mohammad Saleki  3
Affiliations
Review

Pie-Crusting Technique of Medial Collateral Ligament for Total Knee Arthroplasty in Varus Deformity: A Systematic Review

Mehdi Motififard et al. Adv Biomed Res. .

Abstract

Background: We aimed to better understand the outcomes/complications of pie-crusting technique using blade knife during total knee arthroplasty (TKA) in patients with knee genu varum deformity.

Materials and methods: A systematic search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. English and Persian language articles were considered on the use of pie-crusting technique during TKA in patients with knee genu varum/varus deformity using related keywords and Medical Subject Headings terms with reported postoperative complications and outcomes.

Results: Primary search resulted in 81 studies of them 9 included in our study (ages ranged: 19 years to 62 years). No perioperative complications and/or any significant differences between pie-crusting and control group were observed. Except for two studies that found no significant positive effect for the use of pie-crusting, other studies found pie-crusting a useful and promising technique. Four studies found significant improvement in pie-crusting group compared to control in terms of functional Knee Society Score (KSS), range of motion (ROM), medial gap, and the knee-specific KKS. Three records found no significant differences in terms of functional KSS, ROM; however, they reported fewer use of constrained inserts or a reasonable correction of femoral tibial angle. No serious complications were reported.

Conclusions: Due to the inconsistency of the results on the efficiency and outcomes of pie-crusting, we cannot make a firm conclusion and more high-quality studies are needed in this regard. However, this method can be considered as a safe method which depends on the skill of surgeon.

Keywords: Arthroplasty; instability; medial collateral ligament; pie-crusting; systematic review; total knee replacement.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of study selection procedure in this systematic review
See this image and copyright information in PMC

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