Coronal alignment in osteoarthritic knees, does it change in flexion?

Changes in coronal alignment in osteoarthritic knees evolving from extension to flexion remain poorly studied. Using an imageless computer-navigation system (Stryker©) we prospectively collected measurements of dynamic coronal pre-implant alignment during primary total knee arthroplasty. Coronal alignment of the osteoarthritic knee was determined at maxi- mal extension and 90° flexion. Measurements were subgrouped as varus (≤-3°), neutral (>-3°, <+3°) or valgus (≥+3°). Of 545 osteoarthritic knees (347 females), coronal alignment in extension was 261 (48%) varus, 197 (36%) neutral and 87 (16%) valgus. Varus extension alignment was more common in male versus female knees (p< .0001). Valgus ex- tension alignment was more common in female versus male knees (p= .002). In flexion, 174 (66%) of varus knees remained varus. Coronal alignment remained unchanged (within +3° ; -3°) in flexion versus extension in approximately half of the OA knees observed. This insight into a changing coronal deformity might contribute to a better understanding of osteoarthritic knee behaviour.

Atraumatic Bucket Handle Abnormality of the Triangular Fibrocartilage Complex in an Adolescent.

Background Congenital abnormalities of the triangular fibrocartilage complex (TFCC) are rare and could be mistaken for a traumatic lesion. It is important to recognize these anatomical variations and to realize they do not always require treatment. Case Description An incidental finding of an atraumatic bucket handle abnormality of the TFCC in a 15-year-old male, who was treated arthroscopically for dorsal wrist pain. This structure was resected, thus obtaining a normal looking peripheral TFCC. Literature Review Literature regarding congenital abnormalities of the TFCC is limited to a meniscoid articular disc or a congenital perforation. To our knowledge, an atraumatic bucket handle abnormality has not been described yet. Clinical Relevance This congenital abnormality of the TFCC could be mistaken for a traumatic lesion on MRI, or during wrist arthroscopy; therefore, it is important to realize that this entity may occur and does not require treatment.