{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T11:14:08Z","timestamp":1791285248991,"version":"4.1.0"},"reference-count":12,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2009,3,17]],"date-time":"2009-03-17T00:00:00Z","timestamp":1237248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2009,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We present an algorithmic release approach to the varus knee, including a novel pie crust release technique of the superficial MCL, in 359 total knee arthroplasty patients and report the clinical and radiological outcome. Medio\u2010lateral stability was evaluated as normal in 97% of group 0 (deep MCL), 95% of group 1 (pie crust superficial MCL) and 83% of group 2 (distal superficial MCL). The mean preoperative hip\u2013knee angle was 174.0, 172.1, and 169.5 and was corrected postoperatively to 179.1, 179.2, and 177.6 for groups 0, 1, and 2, respectively. A satisfactory correction in the coronal plane was achieved in 82.9% of all\u2010comers falling within the 180\u00b0 \u00b1 3\u00b0 interval. An algorithmic release approach can be beneficial for soft tissue balancing. In all patients, the deep medial collateral ligament should be released and otseophytes removed. The novel pie crust technique of the superficial MCL is safe, efficient and reliable, provided a medial release of 6\u20138\u00a0mm or less is required. The release of the superficial MCL on the distal tibia is advocated in severe varus knees. Preoperative coronal alignment is an important predictor for the release technique, but should be combined with other parameters such as reducibility of the deformity and the obtained gap asymmetry.<\/jats:p>","DOI":"10.1007\/s00167-009-0755-7","type":"journal-article","created":{"date-parts":[[2009,3,16]],"date-time":"2009-03-16T06:51:35Z","timestamp":1237186295000},"page":"660-666","source":"Crossref","is-referenced-by-count":86,"title":["Soft tissue balancing in varus total knee arthroplasty: an algorithmic approach"],"prefix":"10.1002","volume":"17","author":[{"given":"Peter C. M.","family":"Verdonk","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Centre Albert Trillat Hospices Civils Lyon Lyon France"},{"name":"Department of Orthopaedic Surgery, Poli 5 Ghent University Hospital De Pintelaan 185 9000 Ghent Belgium"},{"name":"Department of Orthopaedic Surgery Stedelijk Ziekenhuis Roeselare Roeselare Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome","family":"Pernin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Centre Albert Trillat Hospices Civils Lyon Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alban","family":"Pinaroli","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Centre Albert Trillat Hospices Civils Lyon Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarik","family":"Ait Si Selmi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Centre Albert Trillat Hospices Civils Lyon Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Neyret","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Centre Albert Trillat Hospices Civils Lyon Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2009,3,17]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"7","article-title":"Osteoarthrosis of the knee. 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