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Total knee replacement after femoral varus osteotomy : Technical challenges and clinical results
By Romain GAILLARD, Sébastien LUSTIG, Elvire SERVIEN, Philippe NEYRET in category TECHNIQUE
Albert Trillat Center, Groupement Hospitalier Nord ; Université Lyon 1, 103 Grande rue de la Croix Rousse, 69004 Lyon, France
The incidence of degenerative knee pathologies is on the rise worldwide, affecting increasingly younger patients who wish to remain physically active for as long as possible. In spite of excellent long term results with Total Knee Replacements (TKR), it remains difficult to recommend an arthroplasty to these young patients, in view of their greater risk of revision surgery in the long term.
Osteotomy is a surgical alternative for young patients that can correct axis deviation of the lower limb and consequently reduce the progression of femorotibial osteoarthritis, meaning that patients can resume regular physical activity [2, 5, 18]. There is a strong indication for Femoral Varus Osteotomy (FVO) in the correction of constitutional valgus deformities of the lower limbs, mainly sited in the femur. This surgical technique has demonstrated excellent long term results [6, 16, 17], although there is a risk of post-operative complications such as stiffness and patellofemoral osteoarthritis . Nonetheless progression of osteoarthritis still remains unavoidable after the procedure, and it is not unusual for a secondary arthroplasty to be performed.
There are a few series describing the results of TKR after FVO [10, 13] and they have highlighted a number of surgical...
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