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Getting an Angle on Knee Replacements

Knee replacements are becoming more and more common. Even patients with severe deformity can have a joint replacement. But it can mean some fancy footwork on the part of the surgeon. In this study, doctors report on a new, simpler method used to replace the knee joint in knees with severe valgus deformity.

Valgus knee deformity is a medical way to describe knock-knees. With the valgus knee much of the load from the body weight presses down on the inner (medial) side of the knee. Bone and soft tissue changes occur making surgery to replace the joint more difficult.

The new soft tissue release for valgus knees presented in this study has good long-term results. It's called an inside-out release.

Forty-two patients had this operation and were followed for at least five years. The authors describe step-by-step how the release is done. They say it is easier to align the bones while keeping the ligaments in balance. The tools and positions used during the operation are discussed.

X-rays were used to see knee joint alignment before and after the surgery. The goal was to reduce pain and improve motion and function by balancing the soft tissues while replacing the joint. Patients improved in their ability to walk and climb stairs. The changes lasted over time and only three patients needed further surgery.

The authors conclude that patients with severe valgus deformity can have a knee joint replacement. The inside-out release makes it possible to restore both joint alignment and
soft tissue balance.

References: Mark Elkus, MD, et al. Total Knee Arthroplasty for Severe Valgus Deformity. In The Journal of Bone and Joint Surgery. December 2004. Vol. 86A. No. 12. Pp. 2671-2677.

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