Postoperative alignment of total knee replacement. Its effect on survival.
Four hundred twenty-one posterior cruciate condylar total knee arthroplasties were performed between 1975 and 1983. Anatomic alignment of the knee was recorded on follow-up evaluations from two months to 13 years postoperatively. Patients were stratified into a normal group that was 5 degrees to 8 degrees anatomic valgus, a varus group that was from 4 degrees anatomic valgus to any degree of varus, and a valgus group that was more than 9 degrees anatomic valgus. There were eight failures, five in the varus group and three in the normal group. There were no failures in the valgus group. Kaplan-Meier survival curves showed no significant difference between normal and valgus groups; however, there was a statistical difference between the valgus and varus and the normal and varus groups. A surgeon should align a total knee prosthesis in neutral or a slight amount of anatomic valgus to give the patient the best chance for long-term survival.
Ritter
M A
MA
Center for Hip and Knee Surgery, Mooresville, Indiana 46158.
Faris
P M
PM
Keating
E M
EM
Meding
J B
JB
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging; D007720:Knee Prosthesis / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000453:epidemiology / Q000601:surgery; D016119:Posterior Cruciate Ligament / Q000601:surgery; D011182:Postoperative Care / Q000706:statistics & numerical data; D011859:Radiography; D012086:Reoperation / Q000706:statistics & numerical data; D016019:Survival Analysis; D017211:Treatment Failure