John Michos

By Nikolopoulos Dimitrios, Sagos George and Michos Ioannis

Proper limb and component alignments as well as soft tissue balance are vital for the longevity and optimal long-term outcomes of total knee arthroplasty (TKA). The majority of orthopedic surgeons agree that the total arthroplasty procedure in valgus knees with a deformity of more than 10° is technically demanding and may prove challenging. At the time of operation, the bone and soft tissue abnormalities that should be corrected make accurate axis restoration, correct component positioning and joint stability attaining a difficult task. Specific pathologic anatomic changes associated with valgus knee should be understood preoperatively and estimated so as to select the proper surgical method, to enhance component position and to restore soft-tissue balancing. The purpose of this chapter is to consider all the valgus knee anatomical variations, to analyze the best preoperative planning and to evaluate the type of implant, constrained or not. Lastly, it will also be underlying the current main approaches and techniques to be proposed in the literature for both bone cuts and soft tissue management of valgus knees and if minimally invasive techniques can be performed in severe deformed knees.

Part of the book: Primary Total Knee Arthroplasty