{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:20:58Z","timestamp":1787764858872,"version":"build-2784847793"},"reference-count":47,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>We aimed to better understand the outcomes\/complications of pie-crusting technique using blade knife during total knee arthroplasty (TKA) in patients with knee genu varum deformity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A systematic search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. English and Persian language articles were considered on the use of pie-crusting technique during TKA in patients with knee genu varum\/varus deformity using related keywords and Medical Subject Headings terms with reported postoperative complications and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Primary search resulted in 81 studies of them 9 included in our study (ages ranged: 19 years to 62 years). No perioperative complications and\/or any significant differences between pie-crusting and control group were observed. Except for two studies that found no significant positive effect for the use of pie-crusting, other studies found pie-crusting a useful and promising technique. Four studies found significant improvement in pie-crusting group compared to control in terms of functional Knee Society Score (KSS), range of motion (ROM), medial gap, and the knee-specific KKS. Three records found no significant differences in terms of functional KSS, ROM; however, they reported fewer use of constrained inserts or a reasonable correction of femoral tibial angle. No serious complications were reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Due to the inconsistency of the results on the efficiency and outcomes of pie-crusting, we cannot make a firm conclusion and more high-quality studies are needed in this regard. However, this method can be considered as a safe method which depends on the skill of surgeon.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/abr.abr_239_21","type":"journal-article","created":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T02:18:03Z","timestamp":1698373083000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["Pie-Crusting Technique of Medial Collateral Ligament for Total Knee Arthroplasty in Varus Deformity: A Systematic Review"],"prefix":"10.4103","volume":"12","author":[{"given":"Mehdi","family":"Motififard","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Kashani University Hospital, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hadi","family":"Ravanbod","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, School of Medicine, Al-Zahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashed","family":"Rahmati","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Saleki","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,5]]},"reference":[{"key":"R1-20240830","first-page":"351","article-title":"Evaluation and analysis of the tibial coronal alignment after total knee replacement with the extramedullary tibial cutting guided by the tibial tubercle and anterior tibial tendon in Chinese patients","volume":"48","author":"Zhao","year":"2016","journal-title":"Beijing Da Xue Xue Bao Yi Xue Ban"},{"key":"R2-20240830","doi-asserted-by":"crossref","first-page":"2535","DOI":"10.4103\/0366-6999.192769","article-title":"Effect of femoral resection on coronal overall alignment after conventional total knee arthroplasty","volume":"129","author":"Zhao","year":"2016","journal-title":"Chin Med J (Engl)"},{"key":"R3-20240830","doi-asserted-by":"crossref","first-page":"63","DOI":"10.2147\/JMDH.S140550","article-title":"Total knee arthroplasty: Improving outcomes with a multidisciplinary approach","volume":"11","author":"Feng","year":"2018","journal-title":"J Multidiscip Healthc"},{"key":"R4-20240830","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.artd.2015.11.002","article-title":"Total knee arthroplasty in patients with extra-articular deformity","volume":"2","author":"Hazratwala","year":"2016","journal-title":"Arthroplast Today"},{"key":"R5-20240830","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.knee.2007.04.004","article-title":"The effect of varus and valgus deformity on results of cementless mobile bearing TKA","volume":"14","author":"Sorrells","year":"2007","journal-title":"Knee"},{"key":"R6-20240830","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1097\/01.blo.0000092987.12414.fc","article-title":"The difficult knee: severe varus and valgus","volume":"416","author":"Engh","year":"2003","journal-title":"Clin Orthopaedics Related Res (1976-2007)"},{"key":"R7-20240830","doi-asserted-by":"crossref","first-page":"2671","DOI":"10.2106\/00004623-200412000-00013","article-title":"Total knee arthroplasty for severe valgus deformity. 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