Preoperative Valgus Alignment Does Not Predict Inferior Outcome of Total Knee Arthroplasty.

Content Provider	Europe PMC
Author	Kahlenberg, Cynthia A. Trivellas, Myra Lee, Yuo-yu Padgett, Douglas E.
Abstract	Background Preoperative valgus deformity is present in an estimated 10–20% of patients undergoing total knee replacement (TKR). Questions/Purposes The objective of this study was to compare the Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores after TKR in a matched cohort of patients with preoperative valgus and varus deformities. Methods This is a matched cohort study of 162 patients with varus native knees and 162 patients with valgus native knees who underwent TKR and were prospectively followed in our institutional registry. Patients matched were based on age, BMI, sex, and severity of preoperative knee deformity, which was classified as mild, moderate, severe varus or valgus, or no deformity. Outcomes were evaluated using the WOMAC preoperatively and at 6 weeks, 3 months, 6 months, and 1 year postoperatively. Results No significant difference was found between the matched varus and valgus cohorts in all WOMAC subdomain scores except for a marginally worse stiffness at 1 year in patients with valgus deformity (WOMAC stiffness, 75.1 varus vs. 70.1 valgus; P = 0.049). This is below the minimal clinically important difference for WOMAC scores. There was no significant difference in postoperative varus/valgus alignment between the two groups (P = 0.092) Conclusion We found no clinically significant difference in any of the WOMAC domains in patients with preoperative varus deformity versus valgus deformity within the first year after TKR. These findings may allow surgeons to more appropriately counsel patients with osteoarthritis with valgus deformity that they can expect similar outcomes compared to patients with varus deformity. Electronic supplementary material The online version of this article (10.1007/s11420-017-9576-2) contains supplementary material, which is available to authorized users.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC5786588&blobtype=pdf
ISSN	15563316
Volume Number	14
DOI	10.1007/s11420-017-9576-2
PubMed Central reference number	PMC5786588
Issue Number	1
PubMed reference number	29398995
Journal	HSS Journal [HSS J]
e-ISSN	15563324
Language	English
Publisher	Springer US
Publisher Date	2017-09-12
Publisher Place	New York
Access Restriction	Open
Rights License	© Hospital for Special Surgery 2017
Subject Keyword	valgus varus tibiofemoral alignment total knee arthroplasty alignment
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Surgery