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General Orthopaedics

Total Knee Arthroplasty in Valgus and Varus in the Knees of One Person

International Society for Technology in Arthroplasty (ISTA) 2012 Annual Congress



Abstract

Background

We have performed total knee arthroplasties for valgus and varus in the knees of one person and investigate the clinical characteristics of these patients and the relationship between the kind of deformity and postoperative result.

Methods

From March 2002 to February 2010, 25 patients who had simultaneous varus and valgus knee deformities underwent total knee arthroplasties and followed more than 12 months were included. The average age was 66.9 years and the average follow-up period was 61.1 months. Follow-up imaging assessments were taken and clinical outcome were evaluated using HSS score at last follow-up.

Results

11 cases had more pain in varus knee and 8 cases had more pain in valgus knee preoperatively. In 11 cases, degenerative scoliosis were associated with the knee deformity and among the cases, 10 cases had valgus deformities in concave side of scoliosis. In three cases, hip deformities were noted in ipsilateral side of the valgus deformity. One case showed both hip deformities with ankylosing spondylitis. Preoperative mean valgus angle was 11.4 degree and varus angle was 7.5 degree. Postoperative valgus and varus angle improved to 6.3 and −5.7 degree. HSS score improved from 64.3 to 84.7 point in valgus deformities and from 62.1 to 85.1 point in varus deformities. Postoperative patellar clunk syndrome was identified in one valgus knee, but resolved by arthroscopic debridement. And postoperatively, one case showed out-toeing gait caused by equinovarus deformity in varus knee, but resolved by correction of foot deformity

Conclusions

Simultaneous or staged total knee arthroplasties in patients with simultaneous varus with contralateral valgus knee deformities brought satisfactory outcomes with regard to objective orthopedic criteria such as radiographic and clinical results. Concave aspect of scoliosis and hip deformity correlate with valgus knee in statistically. But rheumatoid factor and VDRL do not correlate with valgus deformity. And we found no significant difference between the kind of deformity and postoperative result.