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The influence of coronal plane deformity on mediolateral ligament status: an observational study in varus knees

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Abstract
Most surgeons believe that varus deformity leads to progressive tightness of the medial soft tissue envelope and laxity on the lateral side. It is, however, unclear at what stage of the deformity such ligament alterations occur, and whether these are the consequence of intrinsic alterations in the ligaments themselves, or rather due to extrinsic factors such as osteophytes, adhesions to the underlying bone, or other factors which may cause a tightening effect. Thirty-five varus knees that were scheduled for TKA were investigated. Ligament status was evaluated after temporary correction of alignment and removal of osteophytes, using varus/valgus testing with computer navigation technology. Knees with < 10A degrees varus deformity were easily correctable to neutral after correction of the extrinsic factors that could cause medial tightness, and these knees maintained normal mediolateral laxity during varus/valgus stress testing. When coronal plane deformity exceeded 10A degrees, progressive shortening of the medial collateral ligament was noted, as well as progressive stretching of the lateral structures (P < 0.001). This study, therefore, demonstrates that the medial collateral structures become intrinsically shortened when preoperative varus deformity exceeds 10A degrees. Likewise, the lateral soft tissues become stretched. None of these occur when the preoperative deformity is < 10A degrees.
Keywords
Laxity, CONTRACTURE FORMATION, Tightness, Varus deformity, Ligament balancing, FLEXION GAP, ARTHROPLASTY, LAXITY, OSTEOARTHRITIS, PROLIFERATION, ALIGNMENT, HEALTHY, RAT

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Chicago
Bellemans, Johan, Hilde Vandenneucker, Johan Vanlauwe, and Jan Victor. 2010. “The Influence of Coronal Plane Deformity on Mediolateral Ligament Status: An Observational Study in Varus Knees.” Knee Surgery Sports Traumatology Arthroscopy 18 (2): 152–156.
APA
Bellemans, J., Vandenneucker, H., Vanlauwe, J., & Victor, J. (2010). The influence of coronal plane deformity on mediolateral ligament status: an observational study in varus knees. KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 18(2), 152–156.
Vancouver
1.
Bellemans J, Vandenneucker H, Vanlauwe J, Victor J. The influence of coronal plane deformity on mediolateral ligament status: an observational study in varus knees. KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY. 2010;18(2):152–6.
MLA
Bellemans, Johan, Hilde Vandenneucker, Johan Vanlauwe, et al. “The Influence of Coronal Plane Deformity on Mediolateral Ligament Status: An Observational Study in Varus Knees.” KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY 18.2 (2010): 152–156. Print.
@article{1967359,
  abstract     = {Most surgeons believe that varus deformity leads to progressive tightness of the medial soft tissue envelope and laxity on the lateral side. It is, however, unclear at what stage of the deformity such ligament alterations occur, and whether these are the consequence of intrinsic alterations in the ligaments themselves, or rather due to extrinsic factors such as osteophytes, adhesions to the underlying bone, or other factors which may cause a tightening effect. Thirty-five varus knees that were scheduled for TKA were investigated. Ligament status was evaluated after temporary correction of alignment and removal of osteophytes, using varus/valgus testing with computer navigation technology. Knees with {\textlangle} 10A degrees varus deformity were easily correctable to neutral after correction of the extrinsic factors that could cause medial tightness, and these knees maintained normal mediolateral laxity during varus/valgus stress testing. When coronal plane deformity exceeded 10A degrees, progressive shortening of the medial collateral ligament was noted, as well as progressive stretching of the lateral structures (P {\textlangle} 0.001). This study, therefore, demonstrates that the medial collateral structures become intrinsically shortened when preoperative varus deformity exceeds 10A degrees. Likewise, the lateral soft tissues become stretched. None of these occur when the preoperative deformity is {\textlangle} 10A degrees.},
  author       = {Bellemans, Johan and Vandenneucker, Hilde and Vanlauwe, Johan and Victor, Jan},
  issn         = {0942-2056},
  journal      = {KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY},
  keyword      = {Laxity,CONTRACTURE FORMATION,Tightness,Varus deformity,Ligament balancing,FLEXION GAP,ARTHROPLASTY,LAXITY,OSTEOARTHRITIS,PROLIFERATION,ALIGNMENT,HEALTHY,RAT},
  language     = {eng},
  number       = {2},
  pages        = {152--156},
  title        = {The influence of coronal plane deformity on mediolateral ligament status: an observational study in varus knees},
  url          = {http://dx.doi.org/10.1007/s00167-009-0903-0},
  volume       = {18},
  year         = {2010},
}

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