Outcomes following functionally aligned total knee arthroplasty in severe varus deformity

Area of Science:

• Orthopedic Surgery
• Biomechanics
• Arthroplasty

Background:

• Severe varus deformity presents challenges in total knee arthroplasty (TKA).
• Alternative alignment techniques in TKA aim to enhance patient outcomes and satisfaction.
• Functionally aligned TKA is explored for severe varus deformity cases.

Purpose of the Study:

• To evaluate the outcomes of functionally aligned TKA in patients with severe varus deformity.
• To compare clinical outcomes and alignment in severe varus TKA versus a control group with mild varus.

Main Methods:

• Retrospective review of 92 patients with severe varus deformity (>15°) undergoing functionally aligned TKA.
• Comparison with a matched control group (mild varus deformity <10°).
• Intra-operative robotic data and prospective registry data (PROMs, VAS, satisfaction, ROM) were collected.

Main Results:

• 96.7% of severe varus TKAs achieved coronal balance; 7.6% required medial soft tissue release.
• Varus stressed Hip Knee Ankle angle (HKA) corrected by 8.5° (p < 0.001).
• Excellent clinical outcomes and high patient satisfaction reported in both severe varus (91.9%) and control (92.7%) groups.

Conclusions:

• Functionally aligned TKA in severe varus deformity (>15°) results in well-balanced knees.
• This technique achieves excellent clinical outcomes with low rates of soft tissue release.
• Functionally aligned TKA is a viable option for severe varus deformity, improving patient function and satisfaction.