Effect of RO On GB During TKR Severe Varus Deformity

Study Overview
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Brief Summary
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Effect Of Reduction Osteotomy On Gap Balancing During Total Knee Replacement For Severe Varus Deformity

Detailed Description
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Severe varus deformity with a tibio femoral angle of 15° or more as measured on full-length weight-bearing radiographs necessitates extensive release of the medial structures to gain neutral limb alignment during total knee arthroplasty (TKA). progressive releases of the medial structures are performed until medial and lateral envelopes are equally balanced. This technique, however, faces a risk of over-release and subsequent instability, ultimately resulting in the use of a thicker polyethylene insert or even a constrained-type prosthesis. Reduction osteotomy is known as a soft tissue-sparing technique for soft tissue balancing, and it is capable of reducing the amount of release required to balance the knee and of preventing over release of medial structures. Dixon et al . and Mullaji et al . proposed the effectiveness of down-sizing the tibial component in the case of knees with severe varus deformity Aim of the work: Assess the effect of reduction osteotomy on gab balancing during total knee arthroplasty for severe varus deformity -What is the amount of deformity correction achieved with reduction osteotomy during TKA in varus knees? - What is the correlation of amount of deformity correction achieved to the amount of bone osteotomized and the degree of varus deformity?

Official Title
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Effect Of Reduction Osteotomy On Gap Balancing During Total Knee Replacement For Severe Varus Deformity

Conditions
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Genu Varum, Knee Osteoarthritis

Intervention / Treatment
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* Other: tibial reduction osteotomy in total knee replacement


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with severe varus deformity more than 15 degrees (long film-mechanical axis) Patients with bone defect of medial tibial condyle Exclusion Criteria: Patients with extra-articular deformity Patients with valgus deformity

Ages Eligible for Study
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Minimum Age: 55 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: osteoarthritis knee ,severe varus deformity<br>reduction osteotomy in total knee replacement | Other: tibial reduction osteotomy in total knee replacement<br>* reduction osteotomy :downsizing of tibial tray with lateralization<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| HKA angle | standing A.P radiograph | immediate post operative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| functional outcome by knee society score | by knee society score | one year follow up | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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reduction osteotomy, knee arthroplasty