Correction of ligament and bone defects in total arthroplasty of the

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severely valgus knee. Whiteside-L-A. DePaul Biomechanical Research Laboratory, St. Louis, MO 63044. Clin-Orthop. 1993 Mar. (288). P 234-45. One hundred thirty-five knees with valgus deformity were treated with a minimally constrained, cementless total knee replacement using intramedullary alignment for the femur and tibia. Mean valgus angle before surgery was 16 degrees; mean valgus angle after surgery was 7 degrees. Neither alignment nor varus-valgus stability deteriorated during the six-year follow-up period, but the knees with greater than 25 degrees deformity had a tendency to increase posterior laxity. Severely deformed knees required bone grafting of the medial femoral and tibial surfaces. A technique was developed to resect the distal femur measured from the medial femoral condyle and to maintain joint line position. Patellar subluxation and dislocation occurred in fewer than 1% of the cases. Despite the absence of rotational constraint at the articular surface, there was no tendency for patellar stability to deteriorate over time.