Abstract
Introduction
Valgus knees are generally more difficult to get acceptable alignment and balance than the varus knee. Most of these are due to anatomical variations in both the diaphysis of the femur, with low valgus angles (angle between the anatomic and mechanical axis of the femur) and the tibial diaphysis. In addition there are those with dysplastic lateral distal femoral condyle s and low external femoral angles (below 84 degrees)
Aim
To assess the clinical results, patient satisfaction and alignment and balance achieved in those with a pre-operative mechanical valgus above 10 degrees.
Method
There were 1038 Total Knee Replacements (TKR) performed by one surgeon from 2006 to 2012. 274 (26%) had valgus mechanical alignments pre operatively, and of this group there were 84 (31%) that had mechanical axis (MA) > 9degrees. Long leg X-rays were used to assess pre and post-operative and component alignment. Patients were assessed by means of the Knee Society Score and a satisfaction rating.
Results
64% had a post-operative MA < 4 degrees, 34% were between 4 and 6 and 2% > 6 degrees. 89%, 85% and 100% reported knee satisfaction respectively for these 3 groups. The valgus knees in this series with a pre-operative MA = 9 degrees had a satisfaction rate of 90%.
Discussion
Severe valgus knees can be adequately corrected and balanced but need significant release or relative lengthening of the LCL by epicondylar osteotomy. Final alignment did / did not affect outcome or satisfaction.
NO DISCLOSURES
