Total knee replacement on more than 20° valgus: A case control study - 29/05/19
, Matthieu Ehlinger b, c, Bruno Tillie d, Benjamin Puliero b, Nassima Ramdane e, Franck Remy f, Gilles Pasquier athe
French Hip, Knee Society (Société Française de la hanche et du genou)g
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Abstract |
Introduction |
Lower-limb valgus deformity exceeding 20° is a particular case, with few publications assessing the impact of the severity of the valgus. The present retrospective case control study compared a series of>20° valgus versus a series of 10–20° valgus, assessing (1) operative data [approach, type of total knee replacement (TKR)], (2) complications and implant survival, and (3) clinical and radiological results.
Hypothesis |
Severe valgus deformity requires TKR with greater constraint, incurring a higher rate of complications and poorer implant survival.
Material and method |
A multicenter retrospective study for the period January 2006 to December 2010 included 53 patients, with a mean age of 72±10 years, presenting>20° valgus. The study series was matched for age and gender with a series of 53 cases of 10–20° valgus. Convexity laxity was greater in the>20° group (p=0.004).
Results |
There was no significant inter-group difference in approach (p=0.13). Greater constraint was more frequent in the>20° group (7/53 versus 1/53; p=0.03), independently of convexity laxity or Krackow grade (p=0.14). There were 7 complications (13.2%) in the>20° group and 7 in the 10–20° group (NS). Eight-year survivorship was 95.12% in the>20° group and 94.9% in the 10–20° group (p=0.63). There were no significant differences in Oxford score (p=0.30) or HKA angle (p=0.78) at last follow-up.
Conclusion |
The study hypothesis was partially confirmed: greater constraint was more frequent in>20° valgus. The number of complications was low, and survival was identical to that of a control group with less severe deformity.
Level of evidence |
III, retrospectivecase controlstudy.
El texto completo de este artículo está disponible en PDF.Keywords : Knee prosthesis, Valgus knee, Complication, Constrained prosthesis
Esquema
Vol 105 - N° 4
P. 613-617 - juin 2019 Regresar al número
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Bienvenido a EM-consulte, la referencia de los profesionales de la salud.