-
International Orthopaedics Jan 2019Varus knee deformity is very common, and it can be classified according to the severity and reducibility of the deformity. Pre-operative planning is mandatory to obtain... (Review)
Review
Varus knee deformity is very common, and it can be classified according to the severity and reducibility of the deformity. Pre-operative planning is mandatory to obtain a good result. Both clinical and radiological planning should be carefully performed, particularly focused on collateral ligament deficiency. In most of the cases, a postero-stabilized implant is necessary, but in the presence of a varus thrust, a midlevel constrained (MLC) implant may be necessary. Rarely, if a severe extra-articular deformity is present, a femoral osteotomy and a high constrain implant may be necessary. In most of the cases, a standard midline approach can be performed. Soft tissue balancing is crucial, avoiding excessive releases of the medial collateral ligament (MCL). In the presence of severe deformity, more aggressive procedure such as tibial reduction osteotomy or sliding medial epicondyle osteotomy can be performed. In literature, good outcomes are reported for total knee arthroplasty (TKA) in varus deformity. In this manuscript, the available literature on TKA in varus deformity is analyzed, and the preferred surgical techniques of the authors are described.
Topics: Arthroplasty, Replacement, Knee; Femur; Genu Varum; Humans; Knee; Knee Joint; Ligaments, Articular; Osteoarthritis, Knee; Osteotomy; Preoperative Care; Prostheses and Implants; Tibia
PubMed: 30141140
DOI: 10.1007/s00264-018-4116-3 -
American Family Physician Aug 2017Leg and foot problems in childhood are common causes of parental concern. Rotational problems include intoeing and out-toeing. Intoeing is most common in infants and...
Leg and foot problems in childhood are common causes of parental concern. Rotational problems include intoeing and out-toeing. Intoeing is most common in infants and young children. Intoeing is caused by metatarsus adductus, internal tibial torsion, and femoral anteversion. Out-toeing is less common than intoeing and occurs more often in older children. Out-toeing is caused by external tibial torsion and femoral retroversion. Angular problems include genu varum (bowleg) and genu valgum (knock knee). With pes planus (flatfoot), the arch of the foot is usually flexible rather than rigid. A history and physical examination that include torsional profile tests and angular measurements are usually sufficient to evaluate patients with lower extremity abnormalities. Most children who present with lower extremity problems have normal rotational and angular findings (i.e., within two standard deviations of the mean). Lower extremity abnormalities that are within normal measurements resolve spontaneously as the child grows. Radiologic studies are not routinely required, except to exclude pathologic conditions. Orthotics are not beneficial. Orthopedic referral is often not necessary. Rarely, surgery is required in patients older than eight years who have severe deformities that cause dysfunction.
Topics: Adolescent; Child; Child, Preschool; Gait; Humans; Infant; Lower Extremity Deformities, Congenital; Orthopedic Fixation Devices; Physical Examination; Referral and Consultation; Shoes
PubMed: 28925669
DOI: No ID Found -
Journal of the Belgian Society of... 2021: MRI allows to assess deformity and viability of the tibia in Blount disease.
: MRI allows to assess deformity and viability of the tibia in Blount disease.
PubMed: 34622139
DOI: 10.5334/jbsr.2557 -
Acta Ortopedica Brasileira 2020Our objective is to evaluate whether the use of guided growth with eight-plates is more effective than the use of Blount staples for the correction of the idiopathic... (Review)
Review
OBJECTIVE
Our objective is to evaluate whether the use of guided growth with eight-plates is more effective than the use of Blount staples for the correction of the idiopathic genu varum or idiopathic genu valgum.
METHODS
A systematic review (SR) was carried out according to the appropriate methodology for randomized clinical trials (RCTs). We searched seven databases through a previously defined methodology, and we included RCTs, regardless of language, period of publication and status of publication.
RESULTS
Resulted in 6830 articles retrieved. Of theses, we identified 14 potential eligible studies. but just one RCT was included for the SR. The included RCT compares the eight-plate and the Blount staple and showed no statistically significant difference for the outcomes of time to correct the deformity, postoperative pain after 24 hours and postoperative pain after 72 hours. The study is of low or very low level of evidence to determine the most effective technique. We didn't find a RCT that compared the correction of the genu varum.
CONCLUSION
Good quality randomized clinical trials comparing Blount staples versus eight-plaque must be performed to determine which technique is superior for coronal plane corrections.
PubMed: 32788863
DOI: 10.1590/1413-785220202804233440 -
Trauma Monthly May 2015Genu varum is a physical deformity marked by bowing of the leg. One of the risk factors of this musculoskeletal alignment is stress on the knee joint such as with...
BACKGROUND
Genu varum is a physical deformity marked by bowing of the leg. One of the risk factors of this musculoskeletal alignment is stress on the knee joint such as with exercise.
OBJECTIVES
Since the evaluation of genu varum has not been widely studies, this study was conducted to examine the association between genu varum and playing soccer.
MATERIALS AND METHODS
Between Septembers 2010-2012, 750 soccer players and 750 non-soccer players 10-18 years of age were included in the study. A questionnaire of data including age, height, weight, body mass index (BMI), years of soccer participation, the average time of playing soccer per week, previous trauma to the lower limbs, history of any fractures of the knee, previous hospitalizations, and the distance of joint lines between the knees was assessed for all subjects. Chi-square, student t-test, and one-way ANOVA were used for statistical analysis by SPSS v.19.0 software. In all tests, a P value of less than 0.05 was construed as statistically significant.
RESULTS
Both soccer players and controls had genu varum. However, the incidence of genu varum was higher in the soccer players (P = 0.0001) and it was more prevalent in the 16-18 year age group (P = 0.0001). The results revealed a statistically significant association between the degree of practices and the prevalence of genu varum (P = 0.0001). Moreover, previous trauma to the knees and practicing in load-bearing sports led to an increase in the degree of genu varum (P = 0.0001).
CONCLUSIONS
There was a higher incidence of genu varum in soccer players than in control adolescents; the stress and load imposed on the knee joint led to more severe genu varum.
PubMed: 26290852
DOI: 10.5812/traumamon.17184