title: Total knee arthroplasty in valgus knees.
abstract: One hundred thirty-four total knee arthroplasties in 98 patients with a valgus alignment were analyzed. Knees with a preoperative alignment of 10 degrees or greater anatomic valgus were believed suitable for inclusion. The average follow-up period in these patients was 4.5 years (range, two to ten years). One hundred eighteen knees were implanted with a posterior stabilized prosthesis, eight knees with a constrained implant design, four knees with a total condylar prosthesis, and four knees with a cruciate-retaining design. All components in all knees were cemented. A lateral retinacular release was necessary in 76% of the arthroplasties secondary to intraoperative lateral subluxation of the patella. The ligamentous release for balancing these valgus-deformed knees was done from the femur. There were 95 knees (71%) rated as excellent, 27 knees (20%) as good, eight knees (6%) as fair, and four knees (3%) as poor. Postoperatively, 76% of the knees had a tibiofemoral alignment between 5 degrees and 9 degrees valgus with an overall average of 7 degrees valgus (range, 3 degrees varus to 15 degrees valgus). Total knee arthroplasty is a reliable and durable procedure in the treatment of valgus knee arthritis. However, valgus-deformed knees represent a greater challenge than their varus counterparts to the implant surgeon in terms of the intraoperative balancing required. This may be a function of the greater difficulty in achieving ligamentous equilibrium and the relative rarity of valgus-deformed knees.
authors.affiliation: Department of Orthopaedic Surgery, Northwestern University, Chicago, Illinois.
authors.forename: S H
authors.initials: SH
authors.lastname: Stern
authors.forename: B H
authors.initials: BH
authors.lastname: Moeckel
authors.forename: J N
authors.initials: JN
authors.lastname: Insall
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000150:complications; D005260:Female; D006801:Humans; D016916:Joint Deformities, Acquired / Q000209:etiology / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery*; D007720:Knee Prosthesis; D008023:Ligaments, Articular / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies