Management of severe valgus knee by total unconstrained arthroplasty: A comparative study with long-term follow-up

Abstract

ObjectiveTo evaluate the use of unconstrained implants in the correction of large valgus deformities using total knee arthroplasty (TKA). Material and methodA total of 817 primary TKA operated between 1998 and 2006 were retrospectively assessed. 50 TKA were selected (group A) in 49 patients, with a minimum deformity of 15° of valgus, 41 cases were included. Another 50 ATR were selected (group B), with a maximum deformity of 15° of varus, finally including 44 cases in 42 patients. The same surgeon performed every operation. The minimum follow-up time was 10 years. The Knee Society Score (KS and FS), the Oxford Knee Score (OKS) and the Range of Mobility (ROM), both preoperative and postoperative at 1, 5 and 10 years, as well as radiographic evolution and complications were evaluated. ResultsPreoperative values of KS, FS and OKS were lower in group A (p<0.0001, p<0.01 and p<0.05, respectively), but not ROM. Postoperatively, KS, FS, OKS and ROM were not different between the groups, neither year, nor 5, nor 10 years. There were also no radiological or complications between the two groups. DiscussionThe use of non-constricted implants in severe valgus was not inferior to the mild varus, implying, in addition, a saving in economic terms, with excellent postoperative results. ConclusionsCorrection of severe valgus deformities can be performed with non-constrained primary implants, without obtaining worse results than those obtained in mild deformities.