Dataset Information

Fixed distal femoral resection with a valgus cutting angle of 3° is more appropriate in intra-articular valgus deformity than juxta-articular valgus deformity in total knee arthroplasty: a retrospective single center study.

ABSTRACT:

Background

The traditionally recommended fixed valgus cutting angle (VCA) of 3° is used as the standard method in total knee arthroplasty (TKA) for valgus deformity. The accuracy of distal femur cutting can be affected by the type of valgus deformity because the intramedullary rod for distal femoral resection can become impinged on the femoral cortex. The purpose of this study is to analyze the accuracy and precision of a VCA of 3° in mechanical alignment in TKA for valgus deformity, based on the type of the deformity.

Methods

TKAs with a fixed VCA of 3° performed in 110 intra-articular and 102 juxta-articular valgus knees were retrospectively reviewed. The age (65.8 vs. 66.1 years), sex (female: male =78/32 vs. 70/32), body mass index (26.0 vs. 26.0), and severity of deformities (valgus 12.1 vs. valgus 12.5) were not significantly different (P>0.647). The mechanical-lateral-distal-femoral angle (mLDFA) and anatomical-mechanical-axis angle (AMA-A) were evaluated. The adjusted-VCA (aVCA) was defined as the maximum angle within the range without the intramedullary rod impinging on the femoral cortex. The proportion of well-aligned femoral component (mLDFA <90°±3°) was assessed. The correlation between AMA-A-3° or aVCA-3° and postoperative mLDFA-90° was analyzed.

Results

Despite the larger AMA-A in the juxta-articular group (6.2° vs. 6.8°, P<0.001), the aVCA was lesser in the juxta-articular group (5.4° vs. 4.1°, P<0.001). The mLDFA was more varus in the intra-articular group (91.7° vs. 90.6°, P<0.001) postoperatively. The proportion of well-aligned femoral component was higher in the juxta-articular group (85.3% vs. 70%, P=0.009). Postoperative mLDFA-90° was moderately correlated with aVCA-3° (r=0.301, r=387), but weakly correlated with AMA-A-3° (r=0.274, r=294) in both groups.

Conclusions

Although a fixed VCA of 3° is a reliable method in achieving mechanical alignment in valgus deformity, it can be more appropriate in juxta-articular deformity than in intra-articular deformity. The aVCA is a more reasonable predictor of femoral component alignment than the AMA-A, considering the femoral cortex impingement of the intramedullary rod.

SUBMITTER: Song SJ

PROVIDER: S-EPMC10929302 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Fixed distal femoral resection with a valgus cutting angle of 3° is more appropriate in intra-articular valgus deformity than juxta-articular valgus deformity in total knee arthroplasty: a retrospective single center study.

Song Sang Jun SJ Lee Hyun Woo HW Kim Young Kook YK Park Cheol Hee CH

Annals of joint 20221015

<h4>Background</h4>The traditionally recommended fixed valgus cutting angle (VCA) of 3° is used as the standard method in total knee arthroplasty (TKA) for valgus deformity. The accuracy of distal femur cutting can be affected by the type of valgus deformity because the intramedullary rod for distal femoral resection can become impinged on the femoral cortex. The purpose of this study is to analyze the accuracy and precision of a VCA of 3° in mechanical alignment in TKA for valgus deformity, bas ...[more]

PMID: 38529156

Similar Datasets

Project description:IntroductionThe aim of this study was to describe the indications and technical aspects of medial closing and lateral opening distal femoral osteotomy (MCDFO and LODFO) for patients with a valgus knee and to report clinical and radiological outcomes and complications.MethodsOver 6 years, 28 DFOs (22 MCDFO, 6 LODFO) were performed in 22 Patients. In this cohort study, we retrospectively analyzed clinical and radiological outcome measures as well as complications.ResultsThe median (range) age was 47 (17-63) years, height 1.68 (1.56-1.98) m, body mass 80 (49-105) kg, and body mass index (BMI) 27.4 (18.6-37.0) kg/m2. The clinical follow-up was 21 (7-81) months, the need for total or unicompartmental knee arthroplasty (TKA/UKA) and hardware removal was followed up for 59 (7-108) months postoperatively. Preoperatively, hip-knee-ankle angle (HKA, negative values denote varus) was 7.0 (2.0-13.0)°, mechanical lateral distal femoral angle (mLDFA) was 83.7 (79.9-88.2)°, and mechanical proximal tibial angle (MPTA) was 89.0 (86.6-94.5)°. Postoperatively, HKA was -1.3 (-9.0-1.2)° and mLDFA was 90.8 (87.3-97.3)°. The incidence of minor and major complications was 25% and 14%, the incidence of delayed and nonunion was 18% and 4%, respectively. At the last follow-up, 18% of the patients had pain at rest, 25% during activities of daily living, and 39% during physical activity, and 71% were satisfied with the outcome. 7% of the cases received a TKA/UKA, 71% received a hardware removal.ConclusionDFO is a reasonable treatment for lateral osteoarthritis in younger patients to avoid disease progression and the need for an UKA/TKA. However, there is a long rehabilitation time, a considerable risk for complications, and a high need for hardware removal. While many patients experienced symptoms at the long-term follow-up, most were satisfied with the outcome. Appropriate patient information is essential. Level of evidence Level IV, Case Series. Trial registration number NCT04382118, clinicaltrials.gov, May 11, 2020.

Dataset Information

Fixed distal femoral resection with a valgus cutting angle of 3° is more appropriate in intra-articular valgus deformity than juxta-articular valgus deformity in total knee arthroplasty: a retrospective single center study.

Background

Methods

Results

Conclusions

Publications

Fixed distal femoral resection with a valgus cutting angle of 3° is more appropriate in intra-articular valgus deformity than juxta-articular valgus deformity in total knee arthroplasty: a retrospective single center study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets