10-YEAR TO 20-YEAR FOLLOW-UP OF TOTAL KNEE ARTHROPLASTY FOR VALGUS DEFORMITIES

One hundred eight knees in 83 patients with a valgus alignment of grea ter than 100 underwent total joint replacement performed by a single s urgeon using the same technique for ligament balancing, which involved releasing the lateral retinaculum and iliotibial band, followed when necessary by detaching the lateral collateral ligament and popliteus t endon from the femur, Sixty knees in 46 patients had follow-up of at l east 10 years and were the focus of study, At an average followup of 1 4.1 years, the mean Knee Society knee score was 88.7 and the mean func tional score was 69.2, Postoperative knee alignment averaged 4.50 with 75% of the knees corrected to between 2 degrees and 7 degrees valgus, Postoperative flexion averaged 101 degrees, There were no cases of pe roneal nerve palsy or patellar dislocation, Six knees underwent revisi on surgery with two for sepsis, three for aseptic loosening, and one f or a traumatic patella fracture, Radiographic component loosening also was seen in one knee, The probability of retention of the prosthesis was 91% (+/-11.7%) at 13.2 years, Although the results in this group o f patients seem acceptable, the rate of postoperative instability for all patients treated using this ligament balancing technique was 24%, Because of the high rate of instability, a new soft tissue release tec hnique has been developed and is the preferred method for ligament bal ancing of the valgus knee during total knee arthroplasty.