Short-term and mid-term results of lateral condyle sliding osteotomy in the treatment of valgus total knee arthroplasty: A successful therapy option in Grade 2 valgus total knee arthroplasty

Abstract

Background: Different methods exist for deformity correction and ligament balancing in total knee arthroplasty (TKA) of valgus knees, the sliding osteotomy being one of them. The objective of the current study was to analyze the clinical and radiological short-term and mid-term results of this technique in a larger series.

Methods: Between June 2007 and May 2014, 98 patients were treated with 98 TKAs and a simultaneous sliding osteotomy. All of them had a Grade 2 fixed valgus deformity (between 10° and 20°). All patients received a mobile-bearing, non-constrained (CR) implant. After prospective inclusion (T1), patients were clinically assessed after one (T2) and 4.5years (±2.1years) (T3), and radiological and Oxford Knee Score (OKS), Knee Society Knee Score (KSS) and the Knee Society Function Score (KSF) were obtained.

Results: All knees were corrected to a mechanical leg alignment within three degrees. Significant improvement of all scores could be measured at T2 and T3. Seven revisions needed to be performed; three of them were procedure-related. In two of them, a problem of capsular closure occurred, while in one the slided epicondyle dislocated after three months. All other revisions were performed because of non-procedure-related problems (e.g. infection).

Conclusions: Sliding osteotomy of the lateral condyle is a successful option for the treatment of Grade 2 fixed valgus deformity. Due to this technique, higher constraint could be avoided. The results stayed constant over time. The procedure-related complications need to be kept in mind. Long-term results still need to be awaited.

Keywords: Mid-term results; Navigation; Sliding osteotomy; Total knee arthroplasty (TKA); Valgus.