Briard Jl. How To Correct Extra Articular Deformity. Slide 1 6

How to correct How to correct extraarticular deformity extraarticular deformity

without causing without causing instabilty ?instabilty ?

Jean-Louis BRIARDJean-Louis BRIARD

Intraarticular spaceIntraarticular space Extraarticular spaceExtraarticular space apart from the apart from the

"collateral ligament "collateral ligament frame"frame"

"bony" component of the deformity"bony" component of the deformity a major aspect in TKRa major aspect in TKR

Need for definitions !

Consider shape of the bones

+ +

(reference to the mechanical axis)

When performing a TKR:When performing a TKR: wellwell aligned in Neutral aligned in Neutral horizontal or perpendicular horizontal or perpendicular

joint line joint line

ie ie normo prosthetic femur & normo prosthetic femur & tibiatibia

stable & mobilestable & mobile

Well aligned kneesWell aligned knees

#1 Consider the orientation of the joint line

"SIMPLE""SIMPLE" Neutral alignmentNeutral alignment Femur ValgumFemur Valgum Tibia VarumTibia Varum

ie well alignedie well aligned

with with an oblique joint linean oblique joint line

FEW PRINCIPLES

but you want an but you want an horizontal joint linehorizontal joint linein Extension:in Extension: resect more medial condyleresect more medial condyle more lateral plateaumore lateral plateauChange anatomical femur valgum in Change anatomical femur valgum in prosthetic normo prosthetic normo

femurfemurAnatomical tibia varum in Anatomical tibia varum in protheticprothetic normo tibianormo tibia