Total Knee Arthroplasty in Severe Valgus Deformity Using a Modified Technique-A 10-Year Follow-Up Study.

Background: Valgus knee deformity accounts for only 10% of total knee arthroplasties (TKAs), but is frequently considered the most challenging to manage. This study provides a 10-year follow-up on a previously reported series of severe valgus knees performed using an unconstrained mobile-bearing TKA with a modified technique to validate this technique. Methods: A consecutive series of 275 predominantly cementless TKAs in 262 patients were performed for severe valgus (>= 10 degrees) deformity and prospectively followed to 10 years. Patient-reported outcome measures included the Oxford Knee Score, American Knee Society Score, Bartlett Patellar Score, and the Short Form 12 questionnaire. Results: Average valgus deformity was reduced from 15.6 degrees to 3.8 degrees (P < .001). At a mean follow-up of 10.4 years (range, 9.5-14.1), 90 (34.4%) patients had died. Of the reviewed survivors, the mean Oxford Knee Score was 27.8 +/- 9.8, with an American Knee Society clinical score of 85.6 +/- 17.0 and a functional score of 65.1 +/- 20.4, with 78% of patients reporting good to excellent results. To date, there has been 1 (0.36%) revision and 13 (4.73%) reoperations. Kaplan-Meier implant survival was 99.6% at 10 years. Conclusion: Despite its challenging nature, the valgus knee is associated with excellent survivorship and satisfactory long-term results using this modified technique. Level of Evidence: Level IV. (C) 2018 Elsevier Inc. All rights reserved.