Abstract
Background and Purpose of Study
The Valgus knee in total knee Arthroplasty, is considered a more demanding procedure, often with ligament balance a greater challenge than seen with neutral or Varus knees. It has also frequently been suggested that prostheses with higher levels of constraint be used to avoid late-onset instability. Various lateral release techniques have also been suggested in the literature.
This study is aimed at assessing the outcomes of an unconstrained, rotating platform designed prosthesis, the LCS, using our technique, in the management of severe valgus deformity.
Methods
44 knees in 42 patients with a pre-operative valgus deformity of more than 10 degrees were included in our retrospective series. We analyzed the radiographs for the degree of correction, the angle of tibial tray implantation, and femoral implantation angle, tibial slope, as well as the presence (or degree) of lift off and any complications were noted.
In this group, 7 had a Valgus deformity of greater than 25 degrees, with a mean Valgus deformity of 17,36 degrees. The mean age at operation was 65. Clinical and radiological analysis was done Pre-hospital discharge and again post-operatively 6 weeks.
Results
The mean coronal alignment was corrected from 17,36 degrees to 5 degrees of Valgus post operatively. 2 knees were corrected past neutral to varus alignment.
There was 1 case of bearing spin out experienced early on in the series. The mean tibial implant angle was 1,7 degrees from neutral. Lift off in the early post-operative X-rays was seen in 6 patients, however at 3 month follow up the knees appeared to be well balanced.
There were no infections or revisions for wear, one re-operation for bearing dislocation, and no cases of loosening in our series.
There were no cases of delayed instability. Patient satisfaction was 86 %.
Conclusions
The rotating platform, mobile bearing prosthesis, using our technique, provided a reproducible correction of deformity in Valgus knees, a well-balanced knee, a low complication rate, and an excellent degree of patient satisfaction.
NO DISCLOSURES
