Published online Jul 6, 2022. doi: 10.12998/wjcc.v10.i19.6406
Peer-review started: July 23, 2021
First decision: September 2, 2021
Revised: September 10, 2021
Accepted: April 21, 2022
Article in press: April 21, 2022
Published online: July 6, 2022
Total knee arthroplasty (TKA) for Ranawat Type II valgus deformity (VD) of the knee is challenging and technical due to resection and soft tissue balance.
Unreasonable osteotomy and soft tissue release in pursuit of neutral femorotibial mechanical axis (FTMA) will increase joint instability, limited prosthesis use, and complications.
This study aimed to provide a new technique of surgical resection, soft tissue release, and FTMA for the VD of the knee during TKA.
Sixty-one patients had a valgus cut angle (VCA) of 5°-7° in the new theory TKA group (NT-TKA). We chose to sacrifice the 2° FTMA to reduce the risk of survival failure, joint installation, and consumption of constrained procedures if the FTMA still cannot return to the neutral position after the maximum soft tissue release. Forty-two patients in the conventional TKA group (C-TKA) were treated with a VCA of 3°-5° and pursuit of neutral FTMA.
The constrained prosthesis usage and complications in NT-TKA were lower than those in C-TKA (P = 0.002 and P = 0.034, respectively). The KSS at 1 mo post-operation for NT-TKA was higher than that in C-TKA (P = 0.007).
Adopting 5°-7° VCA for VD and sacrificing 2° neutral FTMA for severe VD which cannot be completely corrected during TKA can reduce the need for soft tissue release, maintain early joint stability, reduce the use of constrained prostheses, and minimize postoperative complications.
This series of surgical technique for VD of the knee during TKA have certain clinical guiding significance.