Search

Background: Rotational malalignment deformities of the lower limb in adults mostly arise from excessive femoral anteversion and/or excessive external tibial torsion. The aim of this study was to assess the correction accuracy of a patient specific cutting guides (PSCG) used in tibial and femoral correction for lower-limb torsional deformities.Methods: Forty knees (32 patients) were included prospectively. All patients had patellofe-moral pain or instability with torsional malalignment for which a proximal tibial (HTO) or distal femoral (DFO) or a double-level osteotomy (DLO) had been performed. Accuracy of the correction between the planned and the postoperative angular values including femoral anteversion, tibial torsion, coronal and sagittal alignment were assessed after tibial and/or femoral osteotomy.Results: Forty knees were included in this study. In cases of HTO, the correction accuracy obtained with PSCG was 1.3 +/- 1.1 degrees for tibial torsion (axial plane), 0.8 +/- 0.7 degrees for MPTA (coro-nal plane) and 0.8 +/- 0.6 degrees for PPTA (sagittal plane). In cases of DFO, the correction accuracy obtained with PSCG was 1.5 +/- 1.4 degrees for femoral anteversion (axial plane), 0.9 +/- 0.9 degrees for LDFA (coronal plane) and 0.9 +/- 0.9 degrees for PDFA (sagittal plane). The IKSG was improved from 58.0 +/- 13.2 degrees to 71.4 +/- 10.9 (p = 0.04) and the IKSF from 50.2 +/- 14.3 to 87.0 +/- 6.9 (p < 0.001).Conclusions: Using the PSCG for derotational osteotomy allows excellent correction accu-racy in all the three planes for femoral and tibial torsional deformities associated with patellofemoral instability.Level of clinical evidence II, prospective cohort study.(c) 2022 Elsevier B.V. All rights reserved.

Purpose: Calcaneonavicular coalition accounts for more than half of all tarsal coalitions. Resection of calcaneonavicular coalition by an open approach is the standard treatment. Treatment of calcaneonavicular coalition by an arthroscopic approach appears promising. The objective of our study was to compare the clinical outcomes of calcaneonavicular coalition resection by open approach versus arthroscopic approach. Methods: A retrospective cohort study was conducted to evaluate 127 patients who underwent a resection of calcaneonavicular coalition from 2009 to 2017. Patients were divided into two groups according to whether an arthroscopic approach or an open approach was used. Demographics, operative parameters, and clinical outcomes (foot and ankle ability measure score, subjective score, and global ankle estimation) were assessed. Results: Arthroscopic approach was used for 81 patients and open approach for 46 patients. Treatment with arthroscopic approach resulted in a shorter hospital stay (2.6 ± 0.6 days vs 3.0 ± 0.7; p = 0.02) and a longer operative time (24.5 ± 8.1 min vs 20.5 ± 4.2; p Conclusions: Arthroscopic treatment of calcaneonavicular coalition is associated with a higher revision rate than the open approach. Level of evidence: Level III—retrospective comparative study.