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in Flexion to in Flexion to be stable: be stable: (flexion gap) (flexion gap) resect more medial condyle resect more medial condyle femoral component in ER femoral component in ER Gait with the leg & foot Gait with the leg & foot in ER in ER

Briard Jl. How To Correct Extra Articular Deformity. Slide 7 14

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Page 1: 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

Page 2: Briard Jl. How To Correct Extra Articular Deformity. Slide 7 14

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

Page 3: Briard Jl. How To Correct Extra Articular Deformity. Slide 7 14

DEFORMED KNEESDEFORMED KNEESin Current Practicein Current Practice

Page 4: Briard Jl. How To Correct Extra Articular Deformity. Slide 7 14

Genu VarumGenu Varum

mostly a mostly a TibialTibial deformity deformity

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

Page 5: Briard Jl. How To Correct Extra Articular Deformity. Slide 7 14

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)

Page 6: Briard Jl. How To Correct Extra Articular Deformity. Slide 7 14

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

Page 7: Briard Jl. How To Correct Extra Articular Deformity. Slide 7 14

Genu Genu ValgumValgum

FemurFemur Valgum Valgum Normo TibiaNormo Tibia

Page 8: Briard Jl. How To Correct Extra Articular Deformity. Slide 7 14

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