Articles: tibia-surgery.
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Clin. Orthop. Relat. Res. · May 2013
Femoral lateral bowing and varus condylar orientation are prevalent and affect axial alignment of TKA in Koreans.
Coronal alignment is considered key to the function and longevity of a TKA. However, most studies do not consider femoral and tibial anatomical features such as lateral femoral bowing and the effects of these features and subsequent alignment on function after TKA are unclear. ⋯ Lateral femoral bowing, varus condylar orientation, and severe varus inclination of the tibia plateau should be considered when performing TKA in Korean patients or patients with otherwise similar anatomical features.
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Patients presenting with advanced knee osteoarthritis (OA), excessive external tibial torsion (EETT) and chronic patella subluxation pose significant surgical challenges. A combination of TKA, tibial derotation osteotomy, and tibial tuberosity transfer was performed in ten patients (twelve knees) with OA secondary to EETT and patellar instability. ⋯ The mean pre-operative external tibial torsion was 62°, with an average rotational correction of 30°. Significant improvement was found in the Knee Society Score, SF-12 and all WOMAC questionnaire score subscales (p<0.0001); 5 patients had complications, but no loosening or nonunion was seen.
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The tibial fixation site has been reported to be the weakest point in anterior cruciate ligament (ACL) reconstructions. Numerous interference screws and combination screw and sheath devices are available for soft tissue fixation, and a biomechanical comparison of these devices is necessary. ⋯ It is important to consider that these results represent device performance in an in vitro animal model and are not directly transferrable to an in vivo clinical situation. The combination of a sheath and screw did not consistently result in improved fixation characteristics compared with interference screw fixation.
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To report 18 patients who underwent tibiotalocalcaneal arthrodesis using a retrograde intramedullary nail or cannulated screws. ⋯ Tibiotalocalcaneal arthrodesis improved the pain score and quality of life, despite a high risk of complications.
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Posterolateral tibial plateau shear fractures often require buttress plating, which can be performed through a posterolateral approach. The purpose of this study was to provide accurate data about the inferior limit of dissection. ⋯ Displaced posterolateral tibial plateau fractures require anatomic reduction and stabilization with a buttress plate. This can be achieved by gaining access to the posterolateral tibial cortex. The distal limit of this dissection can be as little as 27 mm distal to the lateral tibial plateau. Dissection in this region should be carried out with caution.