Gerard A. Engh

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To correct severe varus or valgus deformity, the surgeon must have clear knowledge of the location, orientation, and physical characteristics of the soft tissue structures that provide stability to the knee. Correct ligament balance restores proper load transfer across the knee and minimizes polyethylene wear. The failure to adequately release contracted(More)
Standard anteroposterior standing radiographs (14 X 17-inch cassettes) and full-limb radiographs (51-inch) from a randomized group of 50 patients undergoing total knee arthroplasty between January 1985 and June 1986 were analyzed. The mean tibiofemoral angle on short films was 5.8 degrees valgus, compared with 7.2 degrees valgus on full-limb films. This 1.4(More)
This study analyzed data from 313 posterior-cruciate-sparing total knee replacements to determine the influence of preoperative flexion on postoperative flexion. The patients with limited flexion preoperatively demonstrated an improvement in flexion postoperatively. By contrast, patients with more than 105 degrees of flexion preoperatively demonstrated a(More)
Many authors have recommended undercorrection of the deformity when carrying out unicompartmental knee arthroplasty (UKA). The isolated effect of alignment of the knee on the outcome of UKA has, however, received little attention. We reviewed 185 UKAs at a minimum of five years after surgery. They had been carried out by a single surgeon using metal-backed(More)
One hundred thirty-six primary total knee arthroplasty patients were randomized for the use of closed-suction, nonreinfusable wound drains. Blood loss was identical in the drained and undrained groups. Forty percent of undrained wounds compared with 0% of drained wounds required dressing reinforcement. Sixty-nine percent of undrained wounds compared with(More)
A comparative analysis of intramedullary and extramedullary alignment was performed in 72 consecutive total knee arthroplasties, using the Moreland Knee Instrument System adapted for the Synatomic knee (DePuy). Six measurements were made from full-length anteroposterior radiographs taken 3 months after operation. Thirty-five of 40 (87.5%) of the(More)
Although the best method for managing large bone defects has not been established, the variables to consider are: (1) implant constraint (posterior-stabilized, varus-valgus-constrained, rotating hinge); (2) stem configuration (straight versus tapered, standard, or long-stemmed); (3) stem fixation (cement versus press-fit); and (4) method of bone-defect(More)
A consecutive series of revision total knee arthroplasties performed at 3 university-affiliated centers by 3 surgeons was prospectively studied. The same implant was used in all cases. The evaluation included a Knee Society clinical score (KSCS); SF-36; satisfaction survey; and radiographs preoperatively, at 6 and 12 months postoperatively, and annually(More)
Little information has been published on the salvage of failed unicompartmental knee arthroplasty. The current authors examined the failure mechanisms, complexity of surgery, and complications in such revisions. Of 39 consecutive unicompartmental knee revisions, two patients died within 2 years of surgery, four had inadequate followup, and one was excluded(More)