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Limb length change after total knee arthroplasty for valgus deformity does not affect the clinical score and is not affected by fixed flexion deformity - 23/03/24

Doi : 10.1016/j.otsr.2023.103787 
Sung-Mok Oh a, Seong-Il Bin b, , Jong-Min Kim b, Bum-Sik Lee b, Jongjin Lee b, Kinam Bae b
a Department of Orthopedic surgery, Barun Hospital, 145, Yeouidaebang-ro, Yeongdeungpo-gu, Seoul, Korea 
b Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, 05505 Seoul, Korea 

Corresponding author at: Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, 05505 Seoul, Korea.Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine88, Olympic-ro 43-gil, Songpa-guSeoul05505Korea

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Abstract

Background

The limb length change (LLC) after total knee arthroplasty (TKA) is especially significant in valgus deformity. The higher LLC could cause higher incidences of lower limb length discrepancy (LLD) and low clinical score. However, studies about LLC after TKA for valgus deformity are limited, and there are none on the relationship between LLC and fixed flexion deformity (FFD) in valgus deformity.

Hypothesis

(1) The amount of LLC would affect the postoperative LLD, (2) the improvement of fixed flexion deformity (FFD) would affect the amount of LLC, (3) The amount of LLC would affect the improvement in the clinical score after TKA for valgus deformity.

Patients and methods

Fifty knees of 50 patients who underwent primary unilateral TKA for valgus-type osteoarthritis between January 2000 and October 2021 were included. A radiological and clinical assessment were performed the day before the operation and at 12 months post-operatively. Full-length standing anteroposterior radiographs were used to measure HKA and LLC. FFD and Hospital for Special Surgery (HSS) score were measured in the outpatient department.

Results

The incidence of lengthening was 92.0% and the mean LLC was 18.85mm (SD, 19.60mm). Postoperative LLD over 10mm occurred in 26% and the mean of postoperative LLD was 4.21mm (SD, 7.96mm). The LLC was correlated with postoperative LLD (rs=0.357, p=0.011) and the HKA change (rs=0.375, p=0.007), but not with the FFD improvement (rs=0.164, p=0.255) and HSS improvement (rs=0.076, p=0.613) or postoperative HSS (rs=0.094, p=0.528).

Conclusion

LLC was affected by HKA improvement but not by FFD improvement after TKA for patients with valgus deformity. Additionally, LLC did not affect the clinical score.

Level of evidence

III; retrospective cohort study.

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Keywords : Limb length change, Total knee arthroplasty, Valgus knee, Flexion deformity, Clinical score

Abbreviations : LLD, LLC, TKA, FFD, HSS, HKA


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Vol 110 - N° 2

Artículo 103787- avril 2024 Regresar al número
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