Abstract
Varus knee deformity is one of the most common deformities presenting for total knee
arthroplasty (TKA). When present, a varus knee deformity contributes to overload of
the medial joint compartment during gait, leading to increased medial compartment
forces as well as lateral soft tissue lengthening. Additionally, a fixed varus deformity
is associated with medial soft tissue contractures of the deep and superficial medial
collateral ligament (MCL) and posteromedial capsule. With a fixed varus deformity,
soft tissue releases may be necessary to create equivalent and rectangular flexion
and extension gaps. There may also be anteromedial tibial bone defects, medial femoral
condyle defects, and occasionally flexion contractures, especially in more severe
cases. In cases of severe varus deformity with medial tibial bone loss, bone defects
must be addressed to ensure adequate implant support. In many cases, a primary knee
implant can be utilized in cases of varus knee deformity, but occasionally prostheses
with higher levels of constraint may be required to balance and stabilize the knee.
TKA has had a successful track record, with high levels of long-term implant survivorship
even in cases of severe varus. Iatrogenic MCL instability and tibial aseptic loosening
are complications associated with TKA in cases of severe varus, and multiple methods
to avoid complications are presented here.
Keywords
orthopaedic surgery - adult reconstruction - arthroplasty - joint replacement - total
knee arthroplasty
