Total Knee Arthroplasty in Patients with Varus Deformities Greater Than Ten Degrees: Survival Analysis at a Mean Ten Year Follow-up

Overview

Journal Int Orthop

Specialty Orthopedics

Date 2018 Jun 23

PMID 29931548

Citations 12

Authors

Benjamin Puliero

Henri Favreau

David Eichler

Philippe Adam

Francois Bonnomet

Matthieu Ehlinger

Affiliations

Soon will be listed here.

Abstract

Introduction: Total knee arthoplasty (TKA) is a secure procedure with more than 90% survival at ten years. The purpose of this study was to report both clinical and radiological outcomes of TKA with a varus > 10°. The second objective was to identify risk factors for failure or bad clinical results. Our hypothesis was that results and survey are comparable to TKA with lesser deformities.

Methods: Eighty-two TKA (69 patients) between January 2004 and December 2008 with a varus > 10° were reviewed retrospectively. The endpoints were clinical (range of motion, IKS knee score, Oxford, and SF-12) and radiological (HKA post-operative and the existence of radiolucent lines or loosening at last follow-up).

Results: Sixty-three TKA (55 patients) were assessed with a mean follow-up of 10.9 years. The global IKS score significantly increased (p = 0.04). Seven TKA needed a revision: two for sepsis, four for aseptic loosening, and one for polyethylene wear, with an overall survival of 91.6% at ten years. For aseptic loosening, the survival rate was 94.7% at ten years. Risk factors for failure were age (p = 0.001), weight (p = 0.04), and a post-operative HKA lesser than 175° (p = 0.05) for aseptic loosening.

Discussion: The hypothesis was confirmed: the results showed a significant improvement of function and quality of life with a survival rate comparable to those found in the literature for greater varus but also inferior to 10°. Three risk factors have been identified suggesting increased surveillance in these cases.

Conclusion: The results of this survey confirm the work hypothesis. Total knee arthroplasty in patients with important axial deformities is a confirmed, reliable, patient-friendly and predictable good outcome procedure.

Citing Articles

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Lee S, Jung J, Kim H, Kim J, Jung I, Kim J J Clin Med. 2024; 13(6).

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Appearance and evolution of radiolucent lines below the tibial implant in primary total knee arthroplasty.

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Fixed-Bearing Posterior-Stabilized Implant versus Constrained Condylar Knee in One-Stage Bilateral Primary Arthroplasty of the Varus Knee: A Randomized Controlled Trial with Minimum 2-year Follow-Up.

Sarzaeem M, Sayyadi S, Pourmojarab A, Omidian M, Bagherian Lemraski M, Baroutkoub M Adv Biomed Res. 2022; 11:34.

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A lateral parapatellar approach with iliotibial band dissection from the Gerdy tubercle for total knee arthroplasty of the valgus knee.

Cheng W, Li Z, Zhang J, Cao Q, Yu H, Qi L Exp Ther Med. 2020; 21(1):38.

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