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Joint Diseases and
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Original Article · Open access

Effects of preoperative valgus deformity in patients undergoing neutrally aligned total knee arthroplasty: A retrospective cohort study with a minimum five-year follow-up

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Xiao-yang Liu

Department of Orthopedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, China

ORCID: 0000-0003-1952-320X

Qiu-ping Yu

Health Management Center, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China

ORCID: 0000-0002-1078-5193

Xu-ming Chen

Department of Orthopedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, China

ORCID: 0009-0006-7989-7106

Wei-nan Zeng

Department of Orthopedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, China

ORCID: 0000-0002-3952-1968

Zong-ke Zhou

Department of Orthopedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, China

ORCID: 0000-0002-9037-4756

Abstract

Objectives: This study aimed to investigate the relationship between the severity of preoperative valgus deformity and clinical outcomes of neutrally aligned total knee arthroplasty (TKA).

Patients and methods: A total of 376 knees with valgus deformity who underwent TKA from January 2006 to March 2014 were retrospectively screened, and 287 knees (242 patients; 32 males, 210 females; mean age: 64.5±8.8 years; range, 35 to 83 years) aligned neutrally after the operation were included. Patients were divided into four groups based on the preoperative hip-knee-ankle (HKA): mild (0°< HKA ≤5°, n=94), moderate (5°< HKA ≤10°, n=74), severe (10°< HKA ≤15°, n=75), and very severe (HKA >15°, n=44) groups. Range of motion (ROM), Knee Society Score (KSS), Visual Analog Scale (VAS) dynamic pain scores, and Forgotten Joint Score (FJS) were evaluated. Mechanical failures were recorded to assess prosthesis survival. A survival rate analysis was performed using Kaplan-Meier survival analysis.

Results: The degree of preoperative valgus deformity did not have a significant impact on the postoperative ROM, KSS, VAS dynamic pain scores, or FJS at the last follow-up. There were no significant differences in cumulative survival rates of neutrally aligned TKAs at 10 years between the four groups (p=0.513).

Conclusion: The severity of preoperative valgus deformity did not affect the clinical outcomes of neutrally aligned TKAs in the minimum five-year follow-up. Additionally, it did not impact the survival rates of neutrally aligned TKAs over 10 years.

* The two authors contributed equally to this study.

Declarations

Ethics Committee Approval

The study protocol was approved by the West China Hospital Ethics Committee (date: 26.09.2022, no: 2022-1564). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Informed Consent

A written informed consent was obtained from each patient.

Author Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed: X.M.C., Q.P.Y., W.N.Z., Z.K.Z.; The first draft of the manuscript was written: X.Y.L., Q.P.Y. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

This research was supported by National Natural Science Foundation of China (grant No. 82172394, U22A20280), and 1·3·5 project for disciplines of excellence, West China Hospital, Sichuan University (grant No: 2023HXFH012, ZYGD23033).

Acknowledgments

We thank all the patients for their participation in our study, and we are grateful to the staff of our department for their support and contribution to this study. And thank the teachers from data center of our hospital for their support to data extraction. All authors declare that they have no financial or personal relationships with other people or organizations that might inappropriately influence this study.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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