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.
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.
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.
LEVEL OF EVIDENCE
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.