Alignment and soft tissue balance of severe varus knee in total knee replacement

ABSTRACT

Twenty-nine cases of severe arthritic knee with various degrees of varus deformity [15°-20°] were treated by total knee replacement. Twenty-one [72.4%] of cases were due to osteo-arthritis of knee while the rest [27.6%] were due to rheumatoid arthritis; bilateral affection was reported in 2 patients. There were 20 males and 7 females whose age ranged from 60 to 74 years. The deformity was partially correctable in nine [31%] cases and fixed in twenty [69%] cases. The aim of surgery was to achieve normal alignment of the limb and joint line and to balance the soft tissue structures on both sides of the joint. This required augmentation of medial compartment in 3 [10.3%] cases by bone graft and fixation by cancellous screws. Normal limb alignment was achieved in twenty-five [86.2%] cases. Four [13.8%] cases had residual varus deformity that ranged from [3°- 5° varus]. In three [10.3%] cases lateral laxity was sill present despite the soft tissue surgery