Primary total knee arthroplasty in severe valgus knee

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• Osteoarthritis (OA) of the knee is a prevalent degenerative joint disease.
• Valgus deformity significantly impacts knee biomechanics and patient quality of life.
• Total knee replacement (TKR) is a common surgical intervention for advanced knee OA.

Purpose of the Study:

• To evaluate the outcomes of primary total knee replacement in patients with knee osteoarthritis and valgus deformity.
• To assess the efficacy of a standard medial parapatellar approach for correcting valgus knee OA.
• To determine the impact of surgical technique on postoperative knee alignment and function.

Main Methods:

• A retrospective study of 28 primary total knee replacements for knee OA with valgus deformity between 2005 and 2007.
• Clinical and radiological assessments included knee range of motion, Knee Society Score (KSS), and femorotibial angle on standing long leg X-rays.
• Preoperative valgus deformity ranged from 6 to over 25 degrees.

Main Results:

• Mean follow-up was 14 months.
• Significant improvements observed in knee range of motion (71° to 95°) and KSS (21.3 to 80.7).
• Mean valgus deformity corrected from 21° to 9° postoperatively.

Conclusions:

• Long leg AP view X-rays in a standing position are essential for evaluating valgus deformity.
• The standard medial parapatellar approach is suitable for TKR in valgus knees, avoiding lateral approach complications.
• Judicious soft tissue balancing is crucial for achieving a well-aligned and stable knee post-surgery.