Total knee arthroplasty in the varus knee: tips and tricks

International Orthopaedics
Roberto RossiFederica Rosso

Abstract

Varus knee deformity is very common, and it can be classified according to the severity and reducibility of the deformity. Pre-operative planning is mandatory to obtain a good result. Both clinical and radiological planning should be carefully performed, particularly focused on collateral ligament deficiency. In most of the cases, a postero-stabilized implant is necessary, but in the presence of a varus thrust, a midlevel constrained (MLC) implant may be necessary. Rarely, if a severe extra-articular deformity is present, a femoral osteotomy and a high constrain implant may be necessary. In most of the cases, a standard midline approach can be performed. Soft tissue balancing is crucial, avoiding excessive releases of the medial collateral ligament (MCL). In the presence of severe deformity, more aggressive procedure such as tibial reduction osteotomy or sliding medial epicondyle osteotomy can be performed. In literature, good outcomes are reported for total knee arthroplasty (TKA) in varus deformity. In this manuscript, the available literature on TKA in varus deformity is analyzed, and the preferred surgical techniques of the authors are described.

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Citations

Sep 6, 2019·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Sang Jun SongCheol Hee Park
May 21, 2020·Journal of Orthopaedic Surgery·Varah YuenyongviwatTheerawit Hongnaparak
Dec 24, 2018·International Orthopaedics·Matteo Papalia, Francesco Falez
Feb 13, 2021·Der Orthopäde·Ricarda LechnerMichael Christian Liebensteiner
Oct 27, 2021·Haemophilia : the Official Journal of the World Federation of Hemophilia·Liujie ZhengYunfeng Yao

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