Total knee arthroplasty in valgus knees

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• Valgus knee alignment presents unique surgical challenges in total knee arthroplasty.
• Preoperative alignment of 10 degrees or greater valgus was the inclusion criterion.

Purpose of the Study:

• To evaluate the outcomes of total knee arthroplasty in patients with significant preoperative valgus alignment.
• To assess the reliability and durability of total knee arthroplasty for valgus knee arthritis.

Main Methods:

• Retrospective analysis of 134 total knee arthroplasties in 98 patients with valgus alignment.
• Utilized various prosthesis designs (posterior stabilized, constrained, total condylar, cruciate-retaining) with cemented fixation.
• Performed femoral-based ligamentous release and lateral retinacular release in 76% of cases.

Main Results:

• Excellent or good outcomes were achieved in 91% of cases (95% excellent, 20% good).
• Postoperative tibiofemoral alignment averaged 7 degrees valgus (range, 3 degrees varus to 15 degrees valgus).
• Lateral retinacular release was frequently necessary due to patellar subluxation.

Conclusions:

• Total knee arthroplasty is a reliable and durable treatment for valgus knee arthritis.
• Valgus knees require meticulous intraoperative balancing, posing greater challenges than varus knees.
• Achieving ligamentous equilibrium is critical for successful outcomes in valgus knee arthroplasty.