PMC7361896_01
(a) Preoperative anteroposterior, lateral, and sunrise X-ray views displaying tricompartmental osteoarthritis with femoral and tibial deformities, valgus angulation, and tibial osteotomy screws. (b) Preoperative anteroposterior standing bilateral lower extremity X-rays displaying long leg alignment and the mechanical axis with femoral and tibial deformities, valgus angulation, and tibial osteotomy screws.
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Clinical evaluation and radiographic imaging confirmed the diagnosis of severe bone-on-bone tricompartmental osteoarthritis (Figure 1).
(a) Significant ligament imbalance was demonstrated between flexion and extension even after soft tissue release and removal of ACL and osteophytes. (b) The numbers in the right lower corner demonstrate ligament balance in knee flexion after making the tibial cut and moving the femoral component anteriorly and before rotating the femoral component internally. (c) The final ligament balance was demonstrated in knee flexion and extension after femoral component ration with implants.
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We next proceeded with identifying the existing deformity without any correction and with corrective maneuver and checking the balances on the medial and lateral side (Figure 2(a)). Moving the planned femur implant anteriorly and thereby planning to remove more bone posteriorly, we were able to get the numbers closer to the extension gap as evidenced by Figure 2(b).
Postoperative anteroposterior and lateral X-ray views of the status of postrobotic arm-assisted total knee arthroplasty and removal of high tibial osteotomy screws.
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He returned for a follow-up visit in 3 weeks postoperatively (Figure 3).