Accuracy of Fixed Distal Femoral Cut of 5° Valgus in Primary Total Knee Arthroplasty | ||
| The Egyptian Orthopaedic Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 18 October 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/eoj.2025.422704.1088 | ||
| Authors | ||
| Kamel Mohamed Ahmed* 1; Tamer Abdel Mawla Abdel Gawad Ali2; Mahmoud Mohmed Ibrahim Abdelghafar3 | ||
| 1orthopedic dep, faculty of medicine Mansoura university, Mansoura, Egypt | ||
| 2orthopedic department, faculty of medicine, Mansoura university, Mansoura, Egypt. | ||
| 3Orthopedic Department, Faculty of Medicine, Mansoura University | ||
| Abstract | ||
| Abstract Objective: To evaluate the precision of employing a fixed 5° valgus distal femoral cut (DFVC) in restoring coronal plane neutral alignment of the lower limb during primary total knee arthroplasty (TKA) in patients presenting with preoperative varus deformity. Methods: A retrospective radiographic analysis was conducted on 67 primary, uncomplicated TKA procedures performed at the authors' university hospitals from January 2018 to July 2022. Postoperative coronal alignment was assessed using long-leg standing hip-to-ankle radiographs. Mechanical axis alignment was defined by the medial angle between the femoral and tibial mechanical axes, with neutral alignment considered within ±3° of 180°. Femoral component alignment was measured using the mechanical lateral distal femoral angle (mLDFA), with optimal alignment set at 90°±3°. Results: The mean postoperative lower limb mechanical axis alignment was 175.2° (range: 172°–183°), with only 55.2% of cases (n=37) falling within the defined neutral range. The remaining 44.8% (n=30) exhibited varus malalignment (<177°). Mean postoperative mLDFA was 91.9° (range: 86°–97°), with 65.7% of femoral components (n=44) falling within the acceptable range and 34.3% (n=23) classified as outliers. Conclusion: The application of a fixed 5° valgus DFVC during primary TKA in patients with preoperative varus deformity does not reliably restore neutral mechanical alignment. These findings underscore the necessity of individualized preoperative planning, preferably with full-length hip-to-ankle radiographs, to optimize postoperative outcomes. | ||
| Keywords | ||
| Total Knee Arthroplasty (TKA); Distal Femoral Cut (DFVC); Fixed 5° Valgus Angle; Coronal Plane Alignment | ||
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