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Outcomes of cruciate-retaining total knee arthroplasty for osteoarthritis with severe varus deformity

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Abstract

Background

Varus deformity is common in osteoarthritic knee. The purpose of this study was to investigate the clinical and radiographic outcomes after cruciate-retaining (CR) total knee arthroplasty (TKA) for severely varus osteoarthritic knees and compare them to those of mildly to moderately deformed osteoarthritic knees.

Methods

Eight hundred ninety-four subjects were undergone CR TKA, 137 had severe varus deformity (group 1), and 757 had mild-to-moderate deformity (group 2) of the lower limb preoperatively. Pre- and postoperative outcomes were compared between two groups clinically and radiographically.

Results

Mean follow-up period was 54.7 ± 28.9 months. Mean age was 77.8 ± 6.7 years in group 1 and 74.5 ± 7.4 years in group 2 (p < 0.001). Preoperative hip-knee-ankle angle (HKAA) was − 17.7°±2.9° in group 1 and − 6.3° ± 5.1° in group 2 (p < 0.001). Preoperative range of motion (ROM) was 127.7° ± 15.2° in group 1 and 130.8 °± 9.6° in group 2 (p = 0.019). Preoperative Knee Society scores and WOMAC score were not significantly different between two groups. Postoperative HKAA was − 0.4° ± 2.3° in group 1 and 0.6 ° ± 2.0° in group 2 (p < 0.001). Postoperative ROM, Knee Society scores, and WOMAC score were not significantly different between two groups.

Conclusions

CR TKA showed results in subjects with severe varus deformities comparable to those without severe varus deformities. Whether the degree of preoperative varus deformity of the lower limb should be considered when deciding to perform CR-type or PS-type TKA requires further discussion.

Level of evidence

Retrospective comparative study, Level III.

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Funding

No funding was provided for this study.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kangwon National University School of Medicine, 1 Gangwondaehak-Gil, Chuncheon-Si, Gangwon-Do, 24341, South Korea

    Jung Ho Noh

  2. Department of Orthopaedic Surgery, Kangwon National University Hospital, 156 Baengnyeong-Ro, Chuncheon-Si, Gangwon-Do, 24289, South Korea

    Ki Ill Song & Yeon Sik Heo

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Contributions

The study design was developed by JHN. KIS and YSH collected the data. Data analysis was performed by JHN. All authors contributed to the writing of the final manuscript.

Corresponding author

Correspondence to Jung Ho Noh.

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Competing interests

JHN, KIS, and YSH have nothing to disclose.

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Consent to publish was obtained from all the authors of this manuscript.

Ethical approval

The present study was conducted upon receiving approval from the institutional review board (IRB). Informed consent was not applicable as this is a retrospective study.

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Noh, J.H., Song, K.I. & Heo, Y.S. Outcomes of cruciate-retaining total knee arthroplasty for osteoarthritis with severe varus deformity. Eur J Orthop Surg Traumatol 33, 2465–2472 (2023). https://doi.org/10.1007/s00590-022-03463-0

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