Knee Function and Subjective Stability Following Total Condylar Arthroplasty in Joints with Preoperative Varus or Valgus Deformity

Kokoszka, Paweł; Markuszewski, Jacek; Łapaj, Łukasz; Kruczyński, Jacek

doi:10.5604/15093492.1186829

Cited by 3 publications

(4 citation statements)

References 17 publications

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“…In a study of the postoperative subjective stability of valgus and varus knees, the results showed that subjective instability was associated with postoperative MCL deficits. 18 In addition, differences in the severity of preoperative knee osteoarthritis and grade of valgus deformity were not associated with clinical outcome after TKA. 19 In our study, patients with valgus deformity had a total of five revisions, two of which were due to laxity of the medial collateral ligament, recurrence of valgus deformity of the knee, and instability.…”

Section: Discussionmentioning

confidence: 92%

“…The follow‐up of VTE after TKA has been rarely reported in previous studies, which only focused on overall postoperative complications. 17 , 18 , 19 Differently, in our study, the incidence of symptomatic VTE, the distribution of thrombus, and the radiographic features were described and recorded in detail for both the valgus and varus groups, and the differences in reasons for prosthesis revision were compared, which is more meaningful for clinical prevention and treatment.…”

Section: Discussionmentioning

confidence: 99%

“…It is not difficult to find from previous studies that valgus knees are significantly more difficult to operate than patients with varus knees because of their special pathological deformity, so the comparison of clinical efficacy and complications after varus and valgus TKA has been the focus of clinical research, and there is also extensive controversy. In a study of the postoperative subjective stability of valgus and varus knees, the results showed that subjective instability was associated with postoperative MCL deficits 18 . In addition, differences in the severity of preoperative knee osteoarthritis and grade of valgus deformity were not associated with clinical outcome after TKA 19 .…”

Section: Discussionmentioning

confidence: 99%

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Effect of Knee Valgus Deformity on Symptomatic Venous Thromboembolism and Prosthesis Revision Risk after Total Knee Arthroplasty: A Multicenter Retrospective Study

Xu,

Zhang,

et al. 2024

Orthopaedic Surgery

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ObjectiveSymptomatic venous thromboembolism (VTE) and prosthesis failure are the most serious complications after total knee arthroplasty (TKA). However, whether knee valgus deformity aggravates these complications has not been fully clarified. To study the difference between perioperative symptomatic VTE and prosthesis revision rate in patients with valgus knee osteoarthritis by comparing with patients undergoing TKA for varus deformity and analyze the reasons for revision. At the same time, the distribution and radiographic features of lower extremity deep venous thrombosis were recorded.MethodsThe data of patients who underwent TKA in two tertiary hospitals from January 2016 to December 2020 were retrospectively reviewed, and a total of 8917 patients were included. According to preoperative manifestations of knee malformations, all patients were divided into two groups: valgus group (n = 412) and varus group (n = 8505). Main indicators included the incidence of symptomatic VTE and prosthesis revision. Secondary outcomes included general information on operative time, Kellgren and Lawrence score, total hospital stay, and total costs. The patient data of the two groups were analyzed by Pearson chi‐square test, Student t test, or Mann–Whitney U test. The revision was evaluated using Kaplan–Meier survival analysis.ResultsThe proportion of valgus knees in TKA patients was 4.62% (412/8917). The incidence of VTE was 6.23‰ (53/8505) and 16.99‰ (7/412) in the varus and valgus groups, and the results were statistically different (p = 0.009). There was no significant difference in echogenicity, number of occluded vessels, and thrombus length between the valgus group (p = 0.102; p = 0.645; p = 0.684). Patients with valgus deformity had 12.14‰ (5/412) prosthesis revision, the incidence of varus deformity was 4.82‰ (41/8505), and the revision risk of valgus group was 2.5 times higher than varus group, and the results were statistically different (p = 0.043). The operation time and hospital stay in the valgus group were longer than those in the varus group, and the results were statistically different (p = 0.018; p < 0.001).ConclusionsValgus deformity increases risk of symptomatic VTE and prosthesis revision after TKA. These results have guiding significance for the prevention of complications after TKA in patients with valgus deformity.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effect of Knee Valgus Deformity on Symptomatic Venous Thromboembolism and Prosthesis Revision Risk after Total Knee Arthroplasty: A Multicenter Retrospective Study

Xu,

Zhang,

et al. 2024

Orthopaedic Surgery

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“…34 Due to excessive loads to the knee, it is known that MCL fibers, in particular, lose elasticity and contraction tension, which increases after postoperative knee correction in various patients who are morbidly obese, and relative laxity develops in the lateral collateral liga-ment. 30,35 Morbid obesity should be included among the risk factors for MCL injury, and we suggest that surgeons must be careful about medial loosening.…”

Section: Discussionmentioning

confidence: 98%

Does Body Mass Index Cause a Clinical Difference in Simultaneous Bilateral and Unilateral Knee Arthroplasty?

et al. 2020

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This study aims to investigate clinical and functional factors in patients undergoing unilateral and simultaneous bilateral total knee arthroplasty (TKA) who were classified into subgroups of nonobese, obese, and morbidly obese, and to determine perioperative and postoperative complications. We conducted an evaluation of 489 nonobese, obese, and morbidly obese patients who underwent TKA due to primary knee osteoarthritis between January 2006 and December 2013. The arthroplasties were performed by three different surgeons. Patients who underwent unilateral (group 1) or simultaneous bilateral (group 2) TKAs were divided into subgroups in accordance with BMI levels, that is, (a) nonobese (BMI < 30 kg/m2), (b) obese (BMI = 30–34.9 kg/m2), and (c) morbidly obese (BMI ≥35 kg/m2). Clinical and functional assessments were performed using Knee Society Scores (KSSs), the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC), and range of motion (ROM) values. Perioperative and early postoperative complications were assessed. The mean follow-up period was 46.65 months (minimum: 24 months; maximum: 84 months). There were no significant differences between the patients undergoing unilateral or simultaneous bilateral TKA procedures regarding postoperative ROM, WOMAC indices, and KSSs (p > 0.05), except for morbidly obese patients. Most intraoperative and early postoperative complications occurred in the morbidly obese group, especially in those undergoing simultaneous bilateral TKA procedures (p < 0.001). Unilateral and simultaneous bilateral TKA procedures showed no differences regarding ROM, clinical scores, and perioperative and early postoperative complications in nonobese and obese patients. A moderate increase was detected in complication rates in the unilateral TKA morbidly obese patients (group 1c); however, morbidly obese patients constituted the major risk group in simultaneous bilateral TKA patients (group 2c) regarding clinical scores (lower WOMAC scores and KSSs) and the development of complications.

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The risk of symptomatic venous thromboembolism after total knee arthroplasty for valgus deformity is comparable to that for varus deformity, but revision is 2.5 times higher

Zhang

Song

et al. 2022

Preprint

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Purpose To study the difference of perioperative symptomatic venous thromboembolism (VTE) and prosthesis revision rate in patients with valgus knee osteoarthritis by comparing with patients undergoing total knee arthroplasty(TKA) for varus deformity and analyze the reasons for revision. At the same time, the distribution and radiographic features of lower extremity deep venous thrombosis were recorded. Methods 8917 patients who underwent primary unilateral TKA in our hospital from 2011 to 2020 were retrospectively analyzed and all patients assigned to two groups: valgus group (n = 412) and varus group (n = 8505). Main indicators included the incidence of symptomatic VTE and prosthesis revision. Secondary outcomes included general information on operative time, Kellgren and Lawrence score, total hospital stay and total costs. Results In our hospital, the proportion of valgus knees in TKA patients was 4.62% (412/8917), the incidence of VTE events was 6.17‰ (55/8917), and most deep venous thrombosis occurred in the distal lower extremities (51/55), mainly in the intermuscular veins (43/53). The incidence of VTE was 6.23‰(53/8505) and 4.85‰(2/412) in the varus and valgus groups, and the results were not statistically different (P = 0.727). There was no significant difference in echogenicity, number of occluded vessels and thrombus length between the valgus group (P = 0.942, P = 0.653, P = 0.684). Total prosthesis revision after TKA was 5.16‰(46/8917), and infection was the main reason for revision (26/46). Patients with valgus deformity had 12.14‰(5/412) prosthesis revision, the incidence of varus deformity was 4.82‰ (41/8505), and the revision risk of valgus group was 2.5 times higher than varus group, and the results were statistically different (P = 0.043). The operation time and hospital stay in the valgus group were longer than those in the varus group, and the results were statistically different (P = 0.018, P < 0.001). Conclusions The proportion of valgus knees in TKA patients in our hospital was 4.62%, which was lower than that in previous reports. Compared with the varus group, no difference was found in the incidence of symptomatic VTE, thrombus location, echogenicity, number of occluded vessels, and thrombus length after TKA in the valgus group, but the prosthesis revision rate was 2.5 times higher in the valgus group than in the varus group,higher revision rates may be associated with longer operative times.

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Knee Function and Subjective Stability Following Total Condylar Arthroplasty in Joints with Preoperative Varus or Valgus Deformity

Cited by 3 publications

References 17 publications

Effect of Knee Valgus Deformity on Symptomatic Venous Thromboembolism and Prosthesis Revision Risk after Total Knee Arthroplasty: A Multicenter Retrospective Study

Effect of Knee Valgus Deformity on Symptomatic Venous Thromboembolism and Prosthesis Revision Risk after Total Knee Arthroplasty: A Multicenter Retrospective Study

Does Body Mass Index Cause a Clinical Difference in Simultaneous Bilateral and Unilateral Knee Arthroplasty?

The risk of symptomatic venous thromboembolism after total knee arthroplasty for valgus deformity is comparable to that for varus deformity, but revision is 2.5 times higher

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