briard jl. how to correct extra articular deformity. slide 7 14

in Flexion toin Flexion tobe stable:be stable:(flexion gap)(flexion gap)resect more medial condyleresect more medial condyle femoral component in ERfemoral component in ER Gait with the leg & foot in ERGait with the leg & foot in ER

So, when you transform So, when you transform

an an anatomicalanatomical (extraarticular) Femur (extraarticular) Femur Valgum (oblique joint line)Valgum (oblique joint line)

into a into a prosthetic prosthetic Normo FemurNormo Femur

in order to be stablein order to be stable

induce rotation of the femoral implant in the horizontal plane

FIRST MESSAGE

DEFORMED KNEESDEFORMED KNEESin Current Practicein Current Practice

Genu VarumGenu Varum

mostly a mostly a TibialTibial deformity deformity

to be simple:to be simple: Normo FemurNormo Femur Tibia VarumTibia Varum

tibial deformity:tibial deformity:change the tibial joint line change the tibial joint line from oblique to perpendicularfrom oblique to perpendicular

medial release (sleeve)medial release (sleeve)

(NB: in some severe tibia varum, you may have to (NB: in some severe tibia varum, you may have to consider an osteotomy)consider an osteotomy)

in flexion:in flexion:

with a strong released, with a strong released, elongated MCLelongated MCL

no change in femoral implant no change in femoral implant rotationrotation

no problem for the patellano problem for the patella

Genu Genu ValgumValgum

FemurFemur Valgum Valgum Normo TibiaNormo Tibia

Femur valgum EA deformityFemur valgum EA deformity Prosthetic normo femurProsthetic normo femur

- reorientate the joint from - reorientate the joint from oblique (oblique (anatomicalanatomical) into ) into horizontal (horizontal (prostheticprosthetic))

- lateral release (difficult)- lateral release (difficult)

- compensate for the lateral - compensate for the lateral condyle bone missingcondyle bone missing