Total Knee Arthroplasty in Valgus Knee

Zorzi, Alessandro Rozim; Brito, Wander Edney de; Campos, Gustavo Constantino de; Miranda, João Batista de

doi:10.5772/intechopen.109573

Cited by 1 publication

(3 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…42 Complex deformities including severe valgus with sagittal plane deformities as well as extra-articular deformities lend themselves to planning and correction using robotic systems. 10,26 CAS navigation has been shown to improve certain aspects of the procedure, as shown by Mullaji et al (2010) using navigation to perform lateral femoral epicondylar osteotomy for precise lengthening of the tight lateral structures and to correct TKR alignment in the arthritic knee with extra-articular deformities. 45,46 The routine use of these technologies in addressing the valgus knee deformity has not been widely adopted; however, knowing that they are available and the proposed benefits as well as drawbacks are important for the practicing orthopaedic surgeon.…”

Section: Technology In the Valgus Kneementioning

confidence: 99%

“…45,46 The routine use of these technologies in addressing the valgus knee deformity has not been widely adopted; however, knowing that they are available and the proposed benefits as well as drawbacks are important for the practicing orthopaedic surgeon. 4,10 New concepts in classification of knee alignment Hirschmann et al (2019) introduced a novel classification for phenotyping of the coronal alignment of the native knee that highlighted the importance of the orientation of the joint line over and above overall limb alignment. 47 They pointed out limitations in the current system of classifying the overall alignment as either valgus, varus or neutral and suggested that the phenotypic classification would be useful in an individualised TKA approach.…”

Section: Technology In the Valgus Kneementioning

confidence: 99%

“…8 These include the surgical exposure, bone cuts, level of implant constraint, gap balancing, preserving the peroneal nerve, balancing the patellofemoral joint and the soft tissue closure. 8,10…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Narrative review of the valgus knee in primary total joint arthroplasty

Almeida,

Sekeitto,

Sikhauli

et al. 2024

SA orthop. j.

View full text Add to dashboard Cite

The valgus knee is less common than the neutral or varus aligned knees in primary total knee arthroplasty (TKA). TKA is technically more challenging in the valgus knee because of the relative difficulty of restoring the joint line, correcting limb alignment, ensuring stability and correcting patellofemoral tracking. Consequently, TKA outcomes are poorer in the valgus knee. The valgus deformity may be intra-or extra-articular or a combination of both, with bony and soft tissue changes resulting in alteration of the rotational profile of the lower limb. Bony changes in the femur include hypoplasia of the distal femur lateral condyle and erosion of the posterior aspect of the lateral condyle. Bony changes in the tibia include remodelling of the lateral tibia plateau and metaphyseal bone. Soft tissue structures on the lateral aspect of the knee may be contracted or tightened with attenuation of the medial stabilising structures. These features contribute to a change in the rotational profile of the knee resulting in external rotation of the tibia and lateral subluxation of the patella with maltracking. Clinical examination should be thorough in both standing and supine positions and must the include the foot and ankle as hindfoot alignment affects the mechanical axis of the weight-bearing lower limb. Neurovascular assessment of the limb should document peroneal nerve integrity as this nerve is at risk of damage at the time of deformity correction. Radiological assessment should, ideally, include long limb weight-bearing views in multiple planes. Computer tomography scanning may be appropriate in cases of severe bony deformities or poorly appreciated anatomical landmarks on standard radiographs. This review delves into the various classification systems for valgus knees and finally, focuses on surgical approaches, appropriate implant choices and technological advancements in the management of the valgus knee. A clear understanding of the pathoanotomy of the valgus knee together with a thorough clinical assessment and appropriate use of technology should help improve outcomes of TKA in the valgus knee.

show abstract