Posterolateral capsular release for correction of valgus deformity

Achieving coronal balance during arthroplasty of a valgus knee presents a challenge for the surgeon. Various techniques for lateral release had been described with no consensus among surgeons. We retrospectively reviewed 42 consecutive patients (38 women, mean age 72.7 years, follow-up 42 ± 23 months) with a valgus deformity who were operated while using a posterolateral capsular release as the sole method of lateral release. All knees were successfully balanced, without the need for further release of other structures. Valgus angles improved from 17.5 ± 4.6 degrees (range 11 to 31) to 6.3 ± 2.2 degrees (range 2 to 11) (p < 0.0001), and the knee and functional scores improved from 5.4 ± 17.7 and 24.8 ± 24.7 to 88.2 ± 15.8 and 70 ± 30, respectively (p < 0.0001) at last follow-up. One patient developed transient peroneal palsy after correction of severe deformity. The posterolateral capsule release, which is similar to that of the "inside-out" technique, provides a simple and safe solution for balancing a valgus knee.