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Total knee arthroplasty for valgus osteoarthritis: the results of a standardized soft-tissue release technique

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

Level of evidence

IV.

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Author information

Authors and Affiliations

  1. Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    Friedrich Boettner, Lisa Renner & Martin Faschingbauer

  2. Department for Orthopedics and Orthopedic Surgery, University of Ulm, 89081, Ulm, Germany

    Martin Faschingbauer

  3. Department of Orthopedic Surgery, Center for Musculosceletal Surgery, Charite Universitaetsmedizin, Chariteplatz 1, 10117, Berlin, Germany

    Lisa Renner

  4. Hospital Galdakao-Usansolo, Servicio de Cirugia Ortopedica y Traumatologia, Barrio Labeaga s/n, 48960, Galdakao, Bizkaia, Spain

    Danik Arana Narbarte

  5. Department of Orthopedics and Traumatology, Kantonsspital St. Gallen, Sankt Gallen, Rorschacher Strasse 95, 9007, St. Gallen, Switzerland

    Claus Egidy

Authors
  1. Friedrich Boettner
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  2. Lisa Renner
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  3. Danik Arana Narbarte
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  4. Claus Egidy
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  5. Martin Faschingbauer
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Corresponding author

Correspondence to Friedrich Boettner.

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Conflict of interest

We certify that we have not signed any agreement with commercial interest related to this study, which would in any way limit publication of any and all data generated for the study or to delay publication for any reason. Dr. Boettner reports personal fees from Smith & Nephew, personal fees from Ortho Development Corporation, personal fees from DePuy Synthes, outside the submitted work. Dr. Faschingbauer reports personal fees from Deutsche Forschungsgemeinschaft (Research Fellowship, FA 1271/1-1, www.dfg.de), during the conduct of the study.

Ethical standard

The authors’ institutional review board approved this study.

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Boettner, F., Renner, L., Arana Narbarte, D. et al. Total knee arthroplasty for valgus osteoarthritis: the results of a standardized soft-tissue release technique. Knee Surg Sports Traumatol Arthrosc 24, 2525–2531 (2016). https://doi.org/10.1007/s00167-016-4054-9

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  • DOI: https://doi.org/10.1007/s00167-016-4054-9

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