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Individual valgus correction angle improves accuracy of postoperative limb alignment restoration after total knee arthroplasty

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of the current study was to compare and investigate the effect of fixed and individual valgus correction angle (VCA) on postoperative alignment restoration. It is hypothesized that individual VCA would be more accurate than fixed VCA in postoperative limb alignment restoration.

Methods

Four hundred and fifty-two patients with 546 consecutive uncomplicated primary total knee arthroplasties performed by a single surgeon, with 302 knees that had individual VCA (group A) and 244 knees that had fixed 5° VCA (group B), were enroled in this study. Preoperative and postoperative full-length standing hip-to-ankle radiographs were used to assess limb alignment. Postoperative hip-knee-ankle angle (θ), femoral component angle (α) and tibial component angle (β) were measured and compared between the two groups.

Results

Mean postoperative θ angle and α angle were 178.9° (SD 1.3°) and 89.1° (SD 1.1°) in the group A, whereas they were 177.8° (SD 1.9°) and 87.9° (SD 1.5°) in the group B. There were significant differences in both parameters between the two groups (p = 0.021 and 0.016, respectively). Mean postoperative β was 89.8° (SD 1.2°) in the group A and 89.7° (SD 1.3°) in the group B, and no significant difference was detected. There were 114 (37.7 %), 221 (73.2 %) and 265 (87.7 %) knees that had restoration of mechanical axis to ±1°, ±2°, ±3° of neutral, respectively, and 37 (12.3 %) outliers (>±3°) in the group A, whereas there were 48 (19.7 %), 122 (50.0 %) and 170 (69.7 %) knees that had restoration of mechanical axis to ±1°, ±2°, ±3° of neutral, respectively, and 74 (30.3 %) outliers in the group B. Group A had a higher percentage of restoration of limb alignment and fewer outliers than those in the group B, and this difference was statistically significant (p < 0.001).

Conclusions

The results from the present study demonstrated that individual VCA for distal femoral resection could enhance the accuracy of postoperative limb alignment restoration compared with fixed VCA. For clinical relevance, individual VCA should be recommended for routine use in all patients in order to achieve the expected postoperative neutral limb alignment and reduce the risk of postoperative malalignment due to the planning error of a fixed VCA.

Level of evidence

Prospective comparative study, Level II.

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Conflict of interest

This work was supported by Health Industry Special Scientific Research Projects of China—The safety and effectiveness evaluation of arthroplasty (201302007).

Ethical standard

Institutional Review Board of West China Hospital of Sichuan University has approved this experiment.

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Authors and Affiliations

  1. The Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China

    Xiaojun Shi, Hai Li, Zongke Zhou, Bin Shen, Jing Yang, Pengde Kang & Fuxing Pei

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  1. Xiaojun Shi
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  2. Hai Li
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  3. Zongke Zhou
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  4. Bin Shen
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  5. Jing Yang
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  6. Pengde Kang
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  7. Fuxing Pei
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Corresponding author

Correspondence to Zongke Zhou.

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Shi, X., Li, H., Zhou, Z. et al. Individual valgus correction angle improves accuracy of postoperative limb alignment restoration after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 25, 277–283 (2017). https://doi.org/10.1007/s00167-014-3496-1

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  • DOI: https://doi.org/10.1007/s00167-014-3496-1

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