By Leo A. Whiteside
The varus knee has a gaggle of bone and ligament abnormalities that needs to be addressed to right the deformity. The mechanical axis of the femur is tilted medially relative to the lengthy axis of the tibia. The distal femoral floor often continues to be in valgus alignment to the lengthy axis of the femur. many of the varus deformity is as a result of deficiency within the medial tibial plateau. The deep and superficial medial collateral ligaments are gotten smaller and deformed by way of osteophytes.
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Extra resources for Ligament Balancing in Total Knee Arthroplasty: An Instructional Manual
The new patellar groove is positioned medially relative to the femoral head, epicondylar axis, and patella. Fig. 106. When the hip is allowed to return to its normal functional position, the epicondylar axis is parallel with the ground, and the tibia is aligned in valgus. The long axis of the tibia passes through this new patellar groove, but not through the center of the femoral head. The patella is positioned laterally. Fig. 107. When the knee is extended, it is stable, and varus-valgus alignment is correct.
A clinical and laboratory study. Orthop Review (suppl) 9-12, 1989. 14. Whiteside LA: Correction of ligament and bone defects in total arthroplasty of the severely valgus knee. Clin Orthop 288:234-245,1993. 15. Whiteside LA: Ligament release and bone grafting in total arthroplasty of the varus knee. Orthopedics 18:117-122, 1995. 16. Whiteside LA, Arima J: The anterior-posterior axis for femoral rotational alignment in valgus total knee arthroplasty. Clin Orthop 321:168-172, 1995. 17. Whiteside LA, Kasselt MR, Haynes DW: Varus and valgus and rotational stability in rotationally unconstrained total knee arthroplasty.
41. The attachment of the posterior cruciate ligament has slid proximally, slackening the posterior cruciate ligament, but tightening the surrounding attachments of the posterior cruciate ligament so that they prevent excessive laxity. Fig. 42. The posterior cruciate ligament, in its new position, allows the tibia to sl ide posteriorly so that the femoral surfaces sit farther forward on the tibia. 28 Fig. 43. After recession the posterior cruciate ligament, occasionally is elongated too much and the secondary posterior stabilizing structures are insufficient to prevent posterior sag.