Correction of Valgus Deformity in Total Knee Arthroplasty With the Pie-Crust Technique of Lateral Soft-Tissue Releases Surgical Technique

摘要

In the arthritic knee, soft-tissue contractures develop as part of the pathologic changes that occur. In the valgus knee, the lateral structures, including the lateral collateral ligament (LCL), iliotibial band, popliteus tendon, and arcuate ligament (posterolateral capsule), gradually shorten. In addition, eventual attenuation of the corresponding medial structures occurs in extreme cases.During total knee arthroplasty (TKA), the soft-tissue tension on the medial and lateral sides must be equalized to create symmetric and balanced flexion and extension gaps. Numerous techniques for establishing balanced soft-tissue tension have been proposed in the valgus knee, yet no consensus exists.Furthermore,although cadaveric studies have been performed to assess the functional role of the lateral soft-tissue structures, little clinical information detailing the effectiveness of these techniques has been reported.8'13'14'16 In particular, little is known about the results of the method, which we have used extensively over the past decade, the so-called piecrust technique.This study was undertaken to evaluate with reproducible, objective methods the results of clinical balancing using the pie-crust technique of lateral soft-tissue releases.