Problem Solution Structures to be released

Varus deformity Medial release 1. Osteophytes

2. Deep medial collateral
ligament ( meniscotibial
ligament
3. Posteromedial corner
with semi membranosus
4. Superficial medial
collateral ligament by
pes anserinus complex
5. Post cruciate ligament
rare

Valgus deformity Lateral release 1. Osteophytes

2. Lateral capsule
3. Iliotabial band if tight in
extension
4. Popliteus if tight in
flexion
5. Lateral collateral
ligament

Scenario Problem Solution

Tight in extension Symmetrical gap Cut more proximal tibia
Tight in flexion
Loose in extention symmetrical gap Use thicker polyethylene insert
Loose in flexion
Extension good , Asymmetrical gap Increase size of femoral
Flexion loose component from ant. To
posterior
Extension tight , Asymmetrical gap Take off more distal femur (1-2
Flexion good mm at a time)
Extension tight , Asymmetrical gap 1. Decrease size of femoral
Flexion good component from ant to
post
2. Assess PCL
3. Check posterior slope
od tibial and recut if
enterior slope is present
Extension loose , Asymmetrical gap Distal femoral augmentation
Flexion good