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Total knee arthroplasty in the varus knee: tips and tricks

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Abstract

Varus knee deformity is very common, and it can be classified according to the severity and reducibility of the deformity. Pre-operative planning is mandatory to obtain a good result. Both clinical and radiological planning should be carefully performed, particularly focused on collateral ligament deficiency. In most of the cases, a postero-stabilized implant is necessary, but in the presence of a varus thrust, a midlevel constrained (MLC) implant may be necessary. Rarely, if a severe extra-articular deformity is present, a femoral osteotomy and a high constrain implant may be necessary. In most of the cases, a standard midline approach can be performed. Soft tissue balancing is crucial, avoiding excessive releases of the medial collateral ligament (MCL). In the presence of severe deformity, more aggressive procedure such as tibial reduction osteotomy or sliding medial epicondyle osteotomy can be performed. In literature, good outcomes are reported for total knee arthroplasty (TKA) in varus deformity. In this manuscript, the available literature on TKA in varus deformity is analyzed, and the preferred surgical techniques of the authors are described.

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Authors and Affiliations

  1. AO Ordine Mauriziano, Orthopaedics and Traumatology Department, Largo Turati 62, 10128, Turin, Italy

    Roberto Rossi, Umberto Cottino, Matteo Bruzzone, Federico Dettoni, Davide Edoardo Bonasia & Federica Rosso

  2. University of Study of Turin, Via Po 8, 10100, Turin, Italy

    Roberto Rossi

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  1. Roberto Rossi
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Correspondence to Federica Rosso.

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Roberto Rossi is a teaching consultant for Zimmer Biomet ®, Depuy Mitek ®, and Smith & Nephew €. The other authors declare that they have no conflict of interest.

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Rossi, R., Cottino, U., Bruzzone, M. et al. Total knee arthroplasty in the varus knee: tips and tricks. International Orthopaedics (SICOT) 43, 151–158 (2019). https://doi.org/10.1007/s00264-018-4116-3

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