Total knee arthroplasty in severe genu valgus. Five to 14 years followup.

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César Angel Pesciallo
Fernando Adrián Lopreite
Harold Simesen de Bielke
Germán Garabano
Damián Fernando Otero
Nicolás Robador
Agustín Oviedo
Hernán Del Sel

Abstract

Introduction: valgus malalignment is a complex, multiplanar deformity characterized by bone alterations and soft-tissue abnormalities. Several surgical techniques have been described for valgus knee, and the sequence of tight lateral structures release and necessity of constrained prosthesis were addressed. Total Knee Arthroplasty (TKA) in valgus deformity remains a surgical challenge for orthopaedic surgeons. The objectives of the study were to evaluate our mid and long-term results in the surgical treatment of severe valgus disease, and describe the applied surgical technique. Materials and Methods: a clinic-radiographic classification was developed, and patients treated for severe genu valgus were discriminated. We retrospectively evaluated 42 TKA in 39 patients, with an average follow-up of 9,2 years. Knee Society Score (KSS) was used for clinical evolution, and the last control best quality radiography was considered for radiographic evaluation. Survivorship analysis contemplated need for revision for any reason and for mechanical failure.Results: postoperative average KSS was 83,3, with marked improvement in parameters pain and range of movement. Constrained implants were utilized in 16,7% of cases. Postoperative alignment was on average 5,9°. Two patients underwent revision surgery, having achieved a prosthetic survivorship for mechanical failure of 97,6%. We did not have any revision because of infection.Conclusion: a meticulous physical examination and proper preoperative radiographs are mandatory. The decision of using a constrained device is done intraoperative. Appropriate soft-tissue release is extremely significant. Despite the surgical technique, a constrained prosthesis utilization is limited. We recommend our technique as a low-demanding procedure, with encouraging mid and long-term results.Key words: valgus, deformity, severe, TKA, release, surgical technique. 

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How to Cite
Pesciallo, C. A., Lopreite, F. A., Simesen de Bielke, H., Garabano, G., Otero, D. F., Robador, N., Oviedo, A., & Del Sel, H. (2016). Total knee arthroplasty in severe genu valgus. Five to 14 years followup. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 81(3), 177-189. https://doi.org/10.15417/378
Section
Clinical Research
Author Biographies

César Angel Pesciallo, Hospital Británico de Buenos Aires

-Equipo de cirugía reconstructiva de cadera y rodilla en Hospital Británico-Equipo de trauma de miembros inferiores en Hospital Británico 

Fernando Adrián Lopreite, Hospital Británico de Buenos Aires

-Equipo de cirugía reconstructiva de cadera y rodilla en Hospital Británico 

Harold Simesen de Bielke, Hospital Británico de Buenos Aires

-Staff de guardia de traumatología en Hospital Británico-Staff de guardia de traumatología en Sanatorio Otamendi y Miroli-Staff de ortopedia general en Hospital Británico -Especialista en cadera y rodilla en UP/ACCORD

Germán Garabano, Hospital Británico de Buenos Aires

-Staff de guardia de traumatología en Hospital Británico-Staff de ortopedia general en Hospital Británico -Especialista en cadera y rodilla y trauma de miembros inferiores en Clínica IMA (Adrogué)

Damián Fernando Otero, Hospital Británico de Buenos Aires

-Staff médico de guardia en Hospital Británico -Staff de columna en Hospital Británico y clínica IMA (Adrogué)

Nicolás Robador, Hospital Británico de Buenos Aires

-Ex residente y fellowship en Artroscopía en Hospital Británico -Médico artroscopista en ciudad de La Rioja

Agustín Oviedo, Hospital Británico de Buenos Aires

-Staff médico de guardia en Hospital Británico -Staff médico de guardia en Sanatorio Otamendi y Miroli -Staff de ortopedia general en Hospital Británico -Especialista en Miembros Superiores en UP/ACCORD

Hernán Del Sel, Hospital Británico de Buenos Aires

-Jefe de Equipo de Cirugía reconstructiva de cadera y rodilla en Hospital Británico -Jefe del servicio de ortopedia y traumatología del Hospital Británico 

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