Correction of severe valgus deformity of knee osteoarthritis with non-constrained total knee arthroplasty implant: A case report

Utomo, Dwikora Novembri; Mahyudin, Ferdiansyah; Yanuar, Andre; Widhiyanto, Lukas; Hernugrahanto, Kukuh Dwiputra

doi:10.1016/j.ijscr.2018.10.080

Cited by 6 publications

(6 citation statements)

References 11 publications

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“…Similar result was found in the second case in which the patient went from 13-degree valgus angle to 6° post-TKA. This improvement is also supported by Dwikora et al using a non-constrained TKA implant technique to correct OA with grade 3 valgus, which achieved stable and painless knee allowing for 10–90° of flexion and complete correction of the patient's valgus deformity within three months post op [22] . Another study by Ren et al which utilized the least constrained implant possible in 62 severe type II valgus knee deformity patients who underwent TKA showed good results with improvements in average valgus degree and range of motion averaged at 110.6° [17] .…”

Section: Discussionmentioning

confidence: 59%

A case series of total knee arthroplasty with a non-constrained implant in 2nd and 3rd degree valgus deformity in knee osteoarthritis and medial collateral ligament insufficiency

Triangga¹,

Magetsari²,

Purnomo³

et al. 2023

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 59%

A case series of total knee arthroplasty with a non-constrained implant in 2nd and 3rd degree valgus deformity in knee osteoarthritis and medial collateral ligament insufficiency

Triangga¹,

Magetsari²,

Purnomo³

et al. 2023

International Journal of Surgery Case Reports

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“…The fact that Utomo et al used a non-constrained TKA implant approach to treat osteoarthritis with grade 2 valgus and were able to create a stable, full correction of the patient's valgus deformity within three months after surgery further supports this method [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Appraisal of Clinical Improvement With Total Knee Arthroplasty in Valgus Knee Deformities: A Case Series

KV,

Ramesh,

Chakrapani

et al. 2024

Cureus

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IntroductionThis case series explores the efficacy of unassisted total knee arthroplasty (TKA) in addressing valgus knee deformity secondary to osteoarthritis. The study aims to evaluate functional outcomes pre-and postsurgery using the Knee Society Score (KSS) and radiological assessments in short-term follow-up. Six patients underwent TKA and were evaluated retrospectively. Statistical analysis revealed significant improvements in the angle of deformity, KSS, and range of motion postoperatively. The study underscores the success of TKA in correcting valgus deformity, improving knee function, and enhancing patient satisfaction.TKA is a highly successful treatment for osteoarthritis, providing functional recovery and improved quality of life. However, valgus knee deformity presents a challenge in TKA, affecting approximately 10% of patients. This study aims to assess the functional outcomes of TKA for valgus deformity using KSS and radiological evaluation in short-term follow-up. Materials and methodsA retrospective observational study was conducted from November 2022 to December 2023, involving six patients with valgus knee deformity secondary to osteoarthritis. TKA was performed with no technological assistance, and patients were assessed pre-and post-surgery using KSS and radiological measurements. Statistical analysis was performed using paired t-tests. Case descriptionSix patients with grade two valgus deformity underwent technology-unassisted TKA. The postoperative assessment revealed significant improvements in the tibiofemoral angle, KSS, and range of motion. The medial parapatellar approach for TKA was utilized with a standard unconstrained primary TKA prosthesis, resulting in successful correction of deformity and improved knee alignment. DiscussionTKA is a widely performed and reliable surgical intervention, with valgus knee deformity posing specific challenges. This study demonstrates the effectiveness of conventional TKA in correcting valgus deformity, improving knee function, and enhancing patient satisfaction in a very small case series. Comparison with previous studies supports the findings of the pre-existing literature, highlighting the importance of appropriate surgical approach and patient selection. ConclusionTKA utilizing a medial parapatellar approach proved effective in our small case series in correcting valgus deformity, improving knee function, and enhancing patient satisfaction. Short-term follow-up reveals significant improvements in stability, posture, and KSS scores. Further assessments and longer-term followup are warranted to confirm the long-term effectiveness of this approach.

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“…Ismailidis et al reported a TKR case of a 90-year-old female with grade III valgus arthritis, having a valgus angle of 47° [ 19 ]. A study by Utomo et al reported a 71-year-old female patient with grade III valgus (32°) arthritis who underwent TKR [ 20 ]. Triangga et al performed TKR on a 56-year-old female with a grade-III (48°) valgus knee and a 62-year-old male with a grade-II (13°) valgus knee experiencing painful OA [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Total Knee Replacement in a Young Patient with Valgus Knee Osteoarthritis: A Case Report

Ahsan,

Ezaz,

Jahan

et al. 2024

jocr

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Introduction: Valgus deformity is characterized by an outward angulation of the knee joint. The most common cause of valgus deformity is osteoarthritis (OA), a prevalent progressive joint disease that causes chronic pain and functional limitations. Total knee replacement (TKR) is rarely done in patients with grade-I valgus deformity and young age. To the best of our knowledge, this is the first case report of its kind. Case Report: A 34-year-old man presented to us with 15 years of persistent, progressively worsening right knee pain that was interfering with his daily activities. No non-operative treatment could alleviate his severe pain. Physical examination revealed a positive valgus stress test, limited knee extension, and an asymmetrical gait. He was diagnosed with a grade-I valgus deformity of the right osteoarthritic knee. History, physical examination, and radiological findings confirmed the diagnosis. In consideration of severe pain and impaired quality of life, we opted to perform TKR using a medial parapatellar approach. Regular follow-ups were done after the procedure. He experienced no pain or recurrence of deformity. He was very satisfied with the result. His Western Ontario and McMaster Universities OA Index score at 12 months following surgery was 5, indicating a favorable outcome. Conclusion: This case exhibits the effectiveness of TKR in treating grade-I valgus deformity of the osteoarthritic knee with severe pain in a young adult, resulting in improved pain alleviation, mobility, joint alignment, and overall quality of life. Keywords: Valgus deformity, osteoarthritic knee, total knee replacement, medial parapatellar approach.

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Correction of severe valgus deformity of knee osteoarthritis with non-constrained total knee arthroplasty implant: A case report

Abstract: HighlightsKnee osteoarthritis with severe valgus deformity is a challenging case.The correction usually requires the use of high-cost constrained knee implant.Non-constrained implant with ligament adjustment provide good outcome.

Cited by 6 publications

References 11 publications

A case series of total knee arthroplasty with a non-constrained implant in 2nd and 3rd degree valgus deformity in knee osteoarthritis and medial collateral ligament insufficiency

A case series of total knee arthroplasty with a non-constrained implant in 2nd and 3rd degree valgus deformity in knee osteoarthritis and medial collateral ligament insufficiency

Appraisal of Clinical Improvement With Total Knee Arthroplasty in Valgus Knee Deformities: A Case Series

Total Knee Replacement in a Young Patient with Valgus Knee Osteoarthritis: A Case Report

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