VALGUS TOTAL KNEE ARTHROPLASTY. RESULTS OF 255 LCS TKA WITH 5 TO 15 YEAR FOLLOW-UP.

P. Keblish; J. Boldt; T. Drobny; U. Munzinger

doi:10.1302/0301-620X.86BSUPP_IV.0860397

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VALGUS TOTAL KNEE ARTHROPLASTY. RESULTS OF 255 LCS TKA WITH 5 TO 15 YEAR FOLLOW-UP.

P. Keblish
J. Boldt
T. Drobny
U. Munzinger

VALGUS TOTAL KNEE ARTHROPLASTY. RESULTS OF 255 LCS TKA WITH 5 TO 15 YEAR FOLLOW-UP.

Keblish P, Boldt J, Drobny T, Munzinger U. VALGUS TOTAL KNEE ARTHROPLASTY. RESULTS OF 255 LCS TKA WITH 5 TO 15 YEAR FOLLOW-UP.. Orthop Procs. 2004;86-B(SUPP_IV):397-397. doi:10.1302/0301-620X.86BSUPP_IV.0860397

Keblish, P., et al. “VALGUS TOTAL KNEE ARTHROPLASTY. RESULTS OF 255 LCS TKA WITH 5 TO 15 YEAR FOLLOW-UP..” Orthopaedic Proceedings, vol. 86-B, no. SUPP_IV, 2004, pp. 397-397., https://doi.org/10.1302/0301-620X.86BSUPP_IV.0860397

Keblish, P., Boldt, J., Drobny, T., & Munzinger, U. (2004). VALGUS TOTAL KNEE ARTHROPLASTY. RESULTS OF 255 LCS TKA WITH 5 TO 15 YEAR FOLLOW-UP.. Orthopaedic Proceedings, 86-B(SUPP_IV), 397-397. https://doi.org/10.1302/0301-620X.86BSUPP_IV.0860397

Keblish, P., Boldt, J., Drobny, T. and Munzinger, U. (2004) “VALGUS TOTAL KNEE ARTHROPLASTY. RESULTS OF 255 LCS TKA WITH 5 TO 15 YEAR FOLLOW-UP..” Orthopaedic Proceedings, 86-B(SUPP_IV), pp. 397-397. Available at: https://doi.org/10.1302/0301-620X.86BSUPP_IV.0860397

Keblish, P., J. Boldt, T. Drobny, and U. Munzinger. “VALGUS TOTAL KNEE ARTHROPLASTY. RESULTS OF 255 LCS TKA WITH 5 TO 15 YEAR FOLLOW-UP..” Orthopaedic Proceedings 86-B, no. SUPP_IV (2004): 397-397. https://doi.org/10.1302/0301-620X.86BSUPP_IV.0860397

Keblish P, Boldt J, Drobny T, Munzinger U. VALGUS TOTAL KNEE ARTHROPLASTY. RESULTS OF 255 LCS TKA WITH 5 TO 15 YEAR FOLLOW-UP.. Orthop Procs. 2004 Apr 1;86-B(SUPP_IV):397-397. https://doi.org/10.1302/0301-620X.86BSUPP_IV.0860397

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Abstract

Correction of fixed valgus is a challenge in primary TKA. Achieving patello-femoral and femoral-tibial stability requires superficial/deep lateral side releases if non-constrained prostheses are utilized. The medial approach has disadvantages with more reported complications. The direct lateral approach, with/without tubercle osteotomy, is an approach option utilized in two reporting centers.

Methods: 255 valgus TKAs with 5- to15-year follow-up were reviewed. Demographics included 91% females, 15% rheumatoid, mean age 69. Prostheses utilized were LCS mobile-bearing (meniscal PCL-retaining/rotating PCL-sacrificing). Patella was non-resurfaced in 90%; cementless fixation in 86%. The direct lateral approach with similar lengthening techniques was used with tubercle osteotomy in one center and osteo-periosteal joint exposure in another.

Results: Good/excellent 91%, modified HSS score improvement 57 to 85. Deformity (12) improved < 8 to 12 points (> 15o valgus to < 5o valgus). ROM improved from mean 11o/97o to 1/110o latest. Technical/prosthetic-related complications included: 7 bearing failures (5 meniscal, 2 rotating platform), 2 aseptic loosenings (tibial), 1 patella ligament rupture and 2 screw loosenings in the osteotomy group, 1 patella re-dislocation in a 75-year-old female with dislocation since age 15 (non-osteotomy group), 2 infections, and 1 re-operation for arthrofibrosis .

Discussion/Conclusion: Valgus TKA using LCS move-able bearings implanted via a direct lateral approach are highly successful regarding stability and patella tracking. Failures correlate with inadequate/de-stabilizing releases and meniscal PCL-retaining prostheses. Rotating bearings allow for better stability and self-adjustment of common mal-rotation variables. The lateral approach allows for direct (step-wise) lengthening releases, improved patellar tracking, and precise gap balancing.

The abstracts were prepared by Nico Verdonschot. Correspondence should be addressed to him at Orthopaedic Research Laboratory, University Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands.