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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-03-2014 | Knee

Unconstrained arthroplasty in type II valgus knees: posterior stabilized or cruciate retaining?

Authors: Chia Liang Ang, Stephanie Fook, Shi Lu Chia, Pak Lin Chin, Ngai Nung Lo, Seng Jin Yeo

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 3/2014

Abstract

Purpose

Type II valgus knees are defined by medial collateral ligament laxity. This paper studies the results of posterior stabilized (PS) and cruciate retaining (CR) knee implants in type II valgus knees.

Methods

From 1999 to 2009, there were 100 type II valgus knees in 95 patients eligible for study (63 PS, 37 CR). Patients had prospectively collected clinical data up to 2 years after surgery.

Results

At 24 months after surgery, the CR group had reduced range of motion (PS: median 126.0°, CR: median 114°; n.s.) and a marginally but statistically significant increased valgus alignment (PS: median 5°, CR: median 6°; p = 0.011). Despite this, both groups produced equal and marked improvements in SF-36, function score and knee score of the Knee Society score, and Oxford knee score.

Conclusions

Overall, both PS and CR implants performed equally well in type II valgus knees at 24 months post-operatively. Further longer-term studies would be warranted to assess for late instability.

Level of evidence

Retrospective, Level III.

Aglietti P, Lup D, Cuomo P, Baldini A, De Luca L (2007) Total knee arthroplasty using a pie-crusting technique for valgus deformity. Clin Orthop Relat Res 464:73–77PubMed

Arbuthnot JE, Wainwright O, Stables G, Rathinam M, Rowley DI, McNicholas MJ (2011) Dysfunction of the posterior cruciate ligament in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 19:893–898PubMedCrossRef

Clark CR, Rorabeck CH, MacDonald S, MacDonald D, Swafford J, Cleland D (2001) Posterior-stabilized and cruciate-retaining total knee replacement: a randomized study. Clin Orthop Relat Res 392:208–212PubMedCrossRef

Dawson J, Fitzpatrick R, Murray D, Carr A (1998) Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg [Br] 80:63–69CrossRef

Easley ME, Insall JN, Scuderi GR, Bullek DD (2000) Primary constrained condylar knee arthroplasty for the arthritic valgus knee. Clin Orthop Relat Res 380:58–64PubMedCrossRef

Elkus M, Ranawat CS, Rasquinha VJ, Babhulkar S, Rossi R, Ranawat AS (2004) Total knee arthroplasty for severe valgus deformity. Five to fourteen-year follow-up. J Bone Joint Surg [Am] 86-A:2671–2676

Favorito PJ, Mihalko WM, Krackow KA (2002) Total knee arthroplasty in the valgus knee. J Am Acad Orthop Surg 10:16–24PubMed

Healy WL, Iorio R, Lemos DW (1998) Medial reconstruction during total knee arthroplasty for severe valgus deformity. Clin Orthop Relat Res 356:161–169PubMedCrossRef

Insall JN (1988) Presidential address to The Knee Society. Choices and compromises in total knee arthroplasty. Clin Orthop Relat Res 226:43–48PubMed

10.

Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the knee society clinical rating system. Clin Orthop Relat Res 248:13–14PubMed

11.

Jacobs WC, Clement DJ, Wymenga AB (2005) Retention versus sacrifice of the posterior cruciate ligament in total knee replacement for treatment of osteoarthritis and rheumatoid arthritis. Cochrane Database Syst Rev 4:CD004803PubMed

12.

Kolisek FR, McGrath MS, Marker DR, Jessup N, Seyler TM, Mont MA, Lowry Barnes C (2009) Posterior-stabilized versus posterior cruciate ligament-retaining total knee arthroplasty. Iowa Orthop J 29:23–27PubMedCentralPubMed

13.

Krackow KA, Jones MM, Teeny SM, Hungerford DS (1991) Primary total knee arthroplasty in patients with fixed valgus deformity. Clin Orthop Relat Res 273:9–18PubMed

14.

Kraus VB, Vail TP, Worrell T, McDaniel G (2005) A comparative assessment of alignment angle of the knee by radiographic and physical examination methods. Arthritis Rheum 52:1730–1735PubMedCrossRef

15.

Kubiak P, Archibeck MJ, White RE Jr (2008) Cruciate-retaining total knee arthroplasty in patients with at least fifteen degrees of coronal plane deformity. J Arthroplasty 23:366–370PubMedCrossRef

16.

Maruyama S, Yoshiya S, Matsui N, Kuroda R, Kurosaka M (2004) Functional comparison of posterior cruciate-retaining versus posterior stabilized total knee arthroplasty. J Arthroplasty 19:349–353PubMedCrossRef

17.

Matsuda Y, Ishii Y, Noguchi H, Ishii R (2005) Varus-valgus balance and range of movement after total knee arthroplasty. J Bone Joint Surg [Br] 87-B(6):804–808CrossRef

18.

McAuley JP, Collier MB, Hamilton WG, Tabaraee E, Engh GA (2008) Posterior cruciate-retaining total knee arthroplasty for valgus osteoarthritis. Clin Orthop Relat Res 466:2644–2649PubMedCrossRef

19.

Pang HN, Yeo SJ, Chong HC, Chin PL, Chia SL, Lo NN (2013) Joint line changes and outcomes in constrained versus unconstrained total knee arthroplasty for the type II valgus knee. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-013-2390-6 PubMed

20.

Politi J, Scott R (2004) Balancing severe valgus deformity in total knee arthroplasty using a lateral cruciform retinacular release. J Arthroplasty 19:553–557PubMedCrossRef

21.

Rajgopal A, Dahiya V, Vasdev A, Kochhar H, Tyagi V (2011) Long-term results of total knee arthroplasty for valgus knees: soft-tissue release technique and implant selection. J Orthop Surg (Hong Kong) 19:60–63

22.

Ranawat AS, Ranawat CS, Elkus M, Rasquinha VJ, Rossi R, Babhulkar S (2005) Total knee arthroplasty for severe valgus deformity. J Bone Joint Surg [Am] 87(Suppl 1(Pt2)):271–284

23.

Russo A, Bragonzoni L, Trozzi C, Zaffagnini S, Neri MP, Bruni D, Marcacci M (2008) Recurrence of varus/valgus deformity after TKR at 3 years’ follow-up. Knee 15:20–25PubMedCrossRef

24.

Sculco TP (2006) The role of constraint in total knee arthroplasty. J Arthroplasty 21:54–56PubMedCrossRef

25.

Stern SH, Moeckel BH, Insall JN (1991) Total knee arthroplasty in valgus knees. Clin Orthop Relat Res 273:5–8PubMed

26.

Takeda M, Ishii Y, Noguchi H, Matsuda Y, Sato J (2011) Changes in varus-valgus laxity after total knee arthroplasty over time. Knee Surg Sports Traumatol Arthrosc 20:1988–1993PubMedCrossRef

27.

Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483PubMedCrossRef

28.

Whiteside LA (1999) Selective ligament release in total knee arthroplasty of the knee in valgus. Clin Orthop Relat Res 367:130–140PubMedCrossRef

Title: Unconstrained arthroplasty in type II valgus knees: posterior stabilized or cruciate retaining?
Authors: Chia Liang Ang
Stephanie Fook
Shi Lu Chia
Pak Lin Chin
Ngai Nung Lo
Seng Jin Yeo
Publication date: 01-03-2014
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 3/2014
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-013-2677-7

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Springer Medicine

Unconstrained arthroplasty in type II valgus knees: posterior stabilized or cruciate retaining?

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

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Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

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