The Orthobullets Podcast CoinFlips | Recon | Severe Post-traumatic Varus Knee in 61M
Dec 17, 2025
Join leading orthopedic surgeons John Mercuri, Michael Ransone, and Joseph Greene as they delve into the complexities of treating a severe post-traumatic varus knee in a 61-year-old man. They share insights on critical alignment strategies and the importance of imaging for surgical planning. Explore innovative techniques like kinematic alignment and the role of advanced technology in surgery. The panel's discussion highlights the delicate balance between respecting soft tissue and restoring native anatomy, ultimately leading to improved patient outcomes.
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Deformity Often From Medial Tibial Defect
- Severe post-traumatic varus often reflects a long-standing medial tibial defect rather than pure collateral incompetence.
- Physical exam (ROM, stress, hip/ankle) and skyline/flexion views clarify what is contracture versus structural deformity.
Get Targeted Additional Knee Views
- Obtain additional plain radiographic views (standing AP, lateral, Rosenberg, skyline) for preop planning.
- Use flexion/weightbearing views and contralateral films selectively to assess slope and pre-arthritic anatomy.
Optimize Glycemic Control Preop
- Evaluate medical optimization before elective TKA; use A1C ≤7.5% as a typical cutoff and check fructosamine for recent glycemic control.
- Cancel if preop finger-stick glucose is repeatedly >200 mg/dL on day-of-surgery.