Total Knee Arthroplasty in Patients With Valgus Deformity

Background: Valgus deformity (more than 10° valgus on anatomical measurement) is seen in about 10% of patients undergoing total knee arthroplasty (TKA). Valgus deformity is a challenge for the surgeons both for gap balancing and constraint choice. Objectives: The aim of this study was to describe a surgical technique to perform TKA in valgus knee. Patients and Methods: We retrospectively reviewed 32 primary TKA in 27 patients (25 females and 2 males), with valgus knee deformity performed since 2006 to 2014. All procedures have been done by the senior author. In the balancing stage of each procedure, the iliotibial band has been released completely in the first step, and then step by step pie crusting of other lateral structures has been done as needed. Preoperative and postoperative data were obtained retrospectively through chart review and review of radiographs. All patients were clinically examined by the senior author. Preoperative and postoperative knee society scores (KSSs) and functional knee society score (functional KSS) were obtained accordingly. Results: The patients had an average age of 68 years (range, 52 83 years) with an average postoperative follow-up period of 47.5 months (range, 12 100 months). The average KSS improved significantly postoperatively from 42 (range, 20 69) to 90 (range, 67 99) (P < 0.0001). The average functional KSS improved significantly (P < 0.0001) from 51.4 (range, 35 70) to 85.5 (range, 45 100) during follow-up. An average preoperative range of motion also improved by 15.6 degrees during the last follow-up visit (P < 0.001). We had no complication in our patients. Conclusions: The results of our study show that complete release of the iliotibial band and step by step pie-crusting of other lateral structures correct valgus deformities in a safe and simple manner with high success rate and less constrained prosthesis.