Economical Total Knee Arthroplasty for Severe Varus and Flexion Deformities: A Prospective Cohort Study | ||
| The Egyptian Journal of Hospital Medicine | ||
| Article 57, Volume 101, Issue 1, October 2025, Pages 5016-5023 PDF (548.94 K) | ||
| DOI: 10.21608/ejhm.2025.457936 | ||
| Abstract | ||
| Background: Severe combined varus and flexion abnormalities in end-stage osteoarthritis provide a complex indication for total knee arthroplasty (TKA), sometimes necessitating expensive augmentations and specialized implants. Objective: This research aimed to assess an efficient, economical surgical technique using typical cruciate-sacrificing implants in conjunction with specific soft-tissue releases and autogenous bone grafting. Patients and methods: A prospective cohort of 20 patients (28 knees) exhibiting sever varus (≥14°) and fixed flexion contracture (≥5°) received cost-effective TKA using a standardized surgical method. Preoperative abnormalities, surgical data, postoperative alignment, range of motion (ROM), knee society clinical and functional ratings, and complications were documented during an average follow-up period of 33 months. Results: The patients had a mean preoperative varus of 24.9° and a flexion contracture of 17.2°. Bone grafting and the use of tibial stems were required in 25.0% and 10.7% of knees respectively. The average correction of postoperative deformity was 25.8°, achieving a limb alignment of 5.9° valgus. Flexion increased to 117° with little extension losses. The knee society knee and function ratings improved dramatically from 30 to 91 and from 29 to 89 respectively. Functional results were classified as excellent or good in 82.1% of knees. Complications were infrequent, impacting 14.3% of knees. Conclusion: This economical approach achieved consistent deformity correction, outstanding functional recovery, and minimal complication rates in patients with severe varus and flexion deformities, indicating a feasible alternative to pricier implant-dependent procedures in resource-limited settings. | ||
| Keywords | ||
| Total knee arthroplasty; Varus deformity; Flexion contracture; Cost-effective surgery; Autograft; Soft tissue release | ||
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