Balancing severe valgus deformity in total knee arthroplasty using a lateral cruciform retinacular release

We report the technique and results of a cruciform lateral release performed on 35 consecutive knees having > or =15 degrees of valgus with minimum 2-year follow-up. The posterior cruciate ligament (PCL) was preserved in all knees. Preoperative valgus averaged 17 degrees, and range of motion averaged 10 degrees to 107 degrees. Postoperative valgus averaged 4.8 degrees, and average postoperative range of motion was 2 degrees to 110 degrees. The PCL was partially released in 5 knees, and further lateral release of the lateral collateral ligament and popliteus were required in 3 knees. Stable flexion and extension gaps were achieved in all cases, and stability was maintained at follow-up. This lateral cruciform retinacular release provides a simple surgical technique for most valgus deformities of the knee and allows for stable ligamentous balancing.