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Lateral femoral sliding osteotomy in total knee arthroplasty with valgus deformity greater than twenty degrees

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Abstract

Purpose

Lateral femoral sliding osteotomy has been reported as an effective technique for total knee arthroplasty (TKA) with significant valgus deformity. This study aims to investigate its utility in TKA with valgus deformity greater than 20°, for which few studies have examined.

Methods

Consecutive TKA patients with valgus deformity treated with the sliding osteotomy at our institution were retrospectively studied. Constraint implants were not used. Radiological and clinical parameters at follow-ups were compared with those pre-operatively. Radiological parameters included the hip-knee-ankle angle (HKA), the anatomical lateral distal femoral angle (aLDFA), the anatomical lateral plateau ankle angle (aLPTA), and the angle between the femoral mechanical axis and transepicondylar line (femoral transepicondylar angle, FTEA) which was used to reflect concurrent extra-articular valgus and corresponding local alignment. Clinical outcome measures included the Knee Society Score and Functional Score.

Results

Twenty-five patients operated on between July 2011 and February 2017 were enrolled. The average follow-up time was 3.3 (1.5~7.9) years. The pre-operative HKA of 202.7 ± 2.3° (equivalent to valgus of 22.7 ± 2.3°) was reduced to 180.4 ± 2.3° at final follow-ups (P < 0.001). The aLFDA, aLPTA, and FTEA were all significantly improved, with the last one increased from 84.2 ± 1.8° to 89.6 ± 1.6° (t = − 11.35, P < 0.001). All clinical scores were significantly improved without major complications.

Conclusions

Lateral femoral sliding osteotomy can be effective and safe for TKA with severe valgus deformity greater than 20°.

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Authors and Affiliations

  1. Department of Orthopaedics, Peking University Third Hospital, No. 49 North Garden Road, Beijing, 100191, China

    Feng Li, Zijian Li & Hua Tian

  2. Department of Orthopaedic Surgery, Stanford University Medical Center, 450 Broadway Street, Redwood City, CA, 94063, USA

    Ning Liu & Kirkham B. Wood

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  1. Feng Li
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  2. Ning Liu
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  3. Zijian Li
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  4. Kirkham B. Wood
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  5. Hua Tian
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Corresponding author

Correspondence to Hua Tian.

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This retrospective study was approved by the hospital ethics committee of the corresponding author’s hospital.

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The authors declare that they have no conflict of interest.

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Li, F., Liu, N., Li, Z. et al. Lateral femoral sliding osteotomy in total knee arthroplasty with valgus deformity greater than twenty degrees. International Orthopaedics (SICOT) 43, 2511–2517 (2019). https://doi.org/10.1007/s00264-019-04295-0

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