| ORIGINAL ARTICLE |
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| Year : 2020 | Volume
: 17
| Issue : 1 | Page : 2-6 |
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Difficult primary total knee arthroplasty in varus knees - A case series study
S Naufal, BP Vinodkumar, CS Vikraman
Department of Orthopaedics, Govt Medical College, Paripally, Kollam, India
Correspondence Address:
B P Vinodkumar
Government Medical College, Kollam, Kerala
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/joasis.joasis_6_20
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Introduction: Common indications for total knee arthroplasty (TKA) underwent in our hospital were severe grade osteoarthritis of the knee. The etiological factors are idiopathic, post-traumatic injury sequel, postinflammatory sequel, and metabolic conditions like gout and pseudogout. The risk factors include obesity, intraarticular fractures, and meniscal injuries. Materials and Methods: Study participants: A total of 12 cases were analyzed. Three of them were male and 9 were female. Four of them underwent cruciate-retaining and 8 cruciate sacrificing procedures. Discussion: The stability of the knee is a complex issue. The deformity and osteophytes affect the ligaments unequally because of different degrees of tightness or laxity in flexion and extension. We found that the most common difficulty arises in primary TKA was due to the medial tibial bony defect. The defects were secured with a graft fixed to the medial tibial condyle with or without utilizing screws. Physiotherapy was started from the next postoperative day onward. Conclusion: The TKA posed three challenges (1) Instability (2) Difficulty in soft-tissue balancing (3) The longevity of tibial tray. These three challenges were overcome by building the defect using bone graft.
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