title: Total knee arthroplasty for valgus osteoarthritis: the results of a standardized soft-tissue release technique.
abstract: OBJECTIVE
  The study reports the 2-year follow-up results of patients with valgus osteoarthritis undergoing total knee arthroplasty (TKA) with a standardized soft-tissue release.
  
  
  METHODS
  Between 2008 and 2013, 222 TKAs were performed for valgus osteoarthritis by a single surgeon. A total of 181 TKAs in 164 patients were available for a minimum 2-year follow-up (range 24-87 months). Preoperative and postoperative range of motion (ROM), mechanical alignment, the postoperative medial proximal tibial angle (MPTA), Western Ontario and McMaster Universities Arthritis Index (WOMAC), VF-12 score, visual analogue pain scale (VAS), and the actual UCLA activity score, desired UCLA score, ligamentous stability (medial collateral ligament) and complications and revision rates were recorded.
  
  
  RESULTS
  The ROM increased from a preoperative flexion contracture of 4.7° (range 0-40) and flexion of 110° (range 35-135) to a postoperative mean flexion contracture of 0.1° (range -5 to 10) and flexion of 128° (range 100-140). The mean hip-knee-ankle alignment was changed from 8.4° of mechanical valgus (range 5.3-25.4) to 0.02° of varus alignment (range -2.9 to 4.1). Tibia component angle (MPTA) was 90.4° (range 86.1-93.7). The WOMAC score, VF-12, UCLA and VAS significantly improved after surgery (p < 0.05). Two patients (1.1 %) underwent revision surgery for instability.
  
  
  CONCLUSIONS
  The described standardized soft-tissue release (release of the iliotibial band and posterolateral corner) provided excellent clinical results at a minimum 2-year follow-up and can be used safely for a "cook-book" approach to the valgus knee with up to 25° mechanical valgus alignment.
  
  
  METHODS
  IV.
authors.affiliation: Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA. boettnerf@hss.edu.
authors.forename: Friedrich
authors.initials: F
authors.lastname: Boettner
authors.affiliation: Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.|Department of Orthopedic Surgery, Center for Musculosceletal Surgery, Charite Universitaetsmedizin, Chariteplatz 1, 10117, Berlin, Germany.
authors.forename: Lisa
authors.initials: L
authors.lastname: Renner
authors.affiliation: Hospital Galdakao-Usansolo, Servicio de Cirugia Ortopedica y Traumatologia, Barrio Labeaga s/n, 48960, Galdakao, Bizkaia, Spain.
authors.forename: Danik
authors.initials: D
authors.lastname: Arana Narbarte
authors.affiliation: Department of Orthopedics and Traumatology, Kantonsspital St. Gallen, Sankt Gallen, Rorschacher Strasse 95, 9007, St. Gallen, Switzerland.
authors.forename: Claus
authors.initials: C
authors.lastname: Egidy
authors.affiliation: Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.|Department for Orthopedics and Orthopedic Surgery, University of Ulm, 89081, Ulm, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Faschingbauer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint / Q000601:surgery; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D056304:Genu Valgum / Q000503:physiopathology*; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010003:Osteoarthritis / Q000601:surgery*; D020370:Osteoarthritis, Knee / Q000601:surgery; D010147:Pain Measurement; D013977:Tibia / Q000601:surgery
keywords: Lateral soft-tissue release; Standardized approach; Total knee arthroplasty; Valgus osteoarthritis