Minor valgus under correction may not affect short-term outcome after TKA

Written By : Dr Supreeth D R |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-04-24T10:15:34+05:30 | Updated On 24 April 2023 1:52 PM IST

Liang Zhou et al conducted a study to investigate the effect of different degrees of valgus deformity correction on patellar position and clinical outcome in patients with valgus knees after total knee arthroplasty (TKA).It has been published in ‘International Orthopaedics’ journal.

The authors retrospectively analyzed and followed 118 patients with valgus knees. Based on the post-operative hip–knee–ankle (HKA), patients were divided into three groups: neutral (±3°), mild (3–6°), and severe (> 6°). Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), range of motion (ROM), and Knee Society Score (KSS) were used to evaluate post-operative clinical efficacy. Also, the patellar tilt angle (ε-angle), congruence angle (θ-angle), and Insall–Salvati index (ISI) were used to represent the patellar position. Post-operative observation indicators included HKA, angle of the femur (α-angle), tibial angle (β-angle), femoral component flexion angle (γ-angle), and tibial component posterior slope angle (δ-angle).

Key findings of the study were:

• All patients showed significant improvements in HKA, ROM, WOMAC, and KSS after operation (P < 0.001).

• Regarding patellar position, the ISI values decreased to varying degrees (P< 0.05).

• The patellar tilt angle was significantly increased in the severe valgus group compared to that in the mild valgus and neutral groups (P <0.001).

• Univariate analysis showed that the degree of post-operative residual valgus was significantly affected by WOMAC, KSS, α-, ε-, and θ-angles.

The authors concluded – “the degree of correction of lower limb alignment after TKA is associated with the clinical effect and will affect the position of the patella; however, a slight insufficient correction will hardly affect short-term clinical efficacy. Moreover, excessive post-operative residual valgus (> 6°) will affect short-term clinical efficacy, and an insufficient correction may increase the risk of poor patellar tracking. Finally, although the height of the patella decreased to different degrees after TKA, the degree of correction did not affect the degree of height reduction.

MBBS, Dip. Ortho, DNB ortho, MNAMS

Dr Supreeth D R (MBBS, Dip. Ortho, DNB ortho, MNAMS) is a practicing orthopedician with interest in medical research and publishing articles. He completed MBBS from mysore medical college, dip ortho from Trivandrum medical college and sec. DNB from Manipal Hospital, Bengaluru. He has expirence of 7years in the field of orthopedics. He has presented scientific papers & posters in various state, national and international conferences. His interest in writing articles lead the way to join medical dialogues. He can be contacted at editorial@medicaldialogues.in.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751