The effect of simultaneous hip and ankle disorders on results AShAriamanesh Jan2016 EsfahanIRAN amp A Coxa vara valga MarchApril 1997 Volume 17 Issue 2 pp 225229 Genu ID: 807806
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Slide1
Osteotomies around the knee;The effect of simultaneous hip and ankle disorders on results
A.Sh.Ariamanesh
Jan.2016
Esfahan-IRAN
Slide2&A) Coxa varavalga
Slide3Slide4Slide5Slide6: March/April 1997 - Volume 17 - Issue 2 - pp 225-229Genu Valgum
in Children with
Coxa
Vara
Resulting from Hip Disease
Shim,
Jong
Sup M.D.
*
; Kim, Hui Taek M.D.†; Mubarak, Scott J. M.D.‡; Wenger, Dennis R. M.D.‡AbstractSummary: Three patients with chronic hip disease and progressive coxa vara deformity also had an unrecognized compensatory ipsilateral genu valgum until the primary hip deformity had been corrected operatively. This unrecognized genu valgum may become subtly worse in a growing child because of lateralization of the mechanical axis of the lower extremity with respect to the knee joint. Operative correction of coxa vara acutely moves the mechanical axis farther laterally, causing the occult genu valgum to become clinically apparent. The genu valgum may subtly worsen over time in a growing child because of lateralization of the lower extremity mechanical axis with respect to the knee joint, with the resulting abnormal Hueter-Volkmann forces across the physis causing progressive genu valgum. Recognition of occult genu valgum before correcting coxa vara in children allows the surgeon the better to advise the family about the need for possible subsequent operations on the knee.
Journal of Pediatric
Orthopaedics
:
March/April 1997 - Volume 17 - Issue 2 - pp 225-229
Coxa
Vara
Slide7Slide8Slide9B) Excess Antiversion
Slide10D) Ankle pain
Slide11Slide12Patients with preoperative varus malalignment frequently had an abnormal
Ankle joint orientation (excessive lateral tilt) relative to the ground in the coronal plane
.
ankle joint line
Paper conclusions;
Slide13The proximal tibial
osteotomy
would change the relative ankle joint line orientation more than the knee joint
line orientation
due to longer lever arm.
Slide14After HTO the relative ankle joint orientation became more parallel to the ground even though the ankle joint orientation after HTO was slightly overcorrected compared to the normal controls probably due to intentional overcorrection strategy in HTO.
Slide15Foot Ankle Int. 2014 Jul;35(7):725-9. doi: 10.1177/1071100714531230. Epub 2014 Apr 9.Ankle Deformity After High
Tibial
Osteotomy
for Correction of
Varus
Knee: A Case Report.
Jeong
BO
1
, SooHoo NF2.Author informationKEYWORDS:ankle; high tibial osteotomy; knee; supramalleolar osteotomyPMID: 24719400 [PubMed - in process]Share on FacebookShare on TwitterShare on Google+
Slide16E) Distal tibial torsions
Slide17A few researches has shown that
tibial
malrotation
affects the distribution of loads
whithin
the knee
.(
Yazdi
,et al
ESSKA 2014)
Slide18Slide19Malrotation of the distal
tibial
fragmnet
negates the intended effect of offloading the diseased compartment
.
Slide20Furthermore leads to abnormal ankle contact pressures.
Slide21No study in the literature.Does constitusional tibial torsion compromise the offloading effect of HTO?
May be
Slide22Every day of life can be a challenge;
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Thanks for your attention