Slight femoral under-correction versus neutral alignment in total knee arthroplasty with preoperative varus knees: a comparative study

Abstract Background This study aimed to compare the short-term clinical results of slight femoral under-correction with neutral alignment in patients with preoperative varus knees who underwent total knee arthroplasty. Methods The medical records and imaging data were retrospectively collected from...

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Main Authors: Kai Lei, Li-Ming Liu, Peng-Fei Yang, Ran Xiong, De-Jie Fu, Liu Yang, Lin Guo
Format: Article
Language:English
Published: BMC 2022-01-01
Series:Arthroplasty
Subjects:
Online Access:https://doi.org/10.1186/s42836-021-00105-4
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author Kai Lei
Li-Ming Liu
Peng-Fei Yang
Ran Xiong
De-Jie Fu
Liu Yang
Lin Guo
author_facet Kai Lei
Li-Ming Liu
Peng-Fei Yang
Ran Xiong
De-Jie Fu
Liu Yang
Lin Guo
author_sort Kai Lei
collection DOAJ
description Abstract Background This study aimed to compare the short-term clinical results of slight femoral under-correction with neutral alignment in patients with preoperative varus knees who underwent total knee arthroplasty. Methods The medical records and imaging data were retrospectively collected from patients who had undergone total knee arthroplasty in our hospital from January 2016 to June 2019. All patients had varus knees preoperatively. Upon 1:1 propensity score matching, 256 patients (256 knees) were chosen and divided into a neutral alignment group (n=128) and an under-correction group (n=128). The patients in the neutral group were treated with the neutral alignment. In the under-correction group, the femoral mechanical axis had a 2° under-correction. The operative time, tourniquet time and the length of hospital stay in the two groups were recorded. The postoperative hip-knee-ankle angle, frontal femoral component angle and frontal tibial component angle were measured. Patient-reported outcome measures were also compared. Results The operative time, tourniquet time and the length of hospital stay in the under-correction group were significantly shorter than the neutral alignment group (P<0.05). At the 2-year follow-up, the under-correction group had a larger varus alignment (P<0.05) and a larger frontal femoral component angle (P<0.05), and the frontal tibial component angles of the two groups were comparable. Compared with the neutral alignment group, the slight femoral under-correction group had significantly better patient-reported outcome measures scores (P<0.05). Conclusion For varus knees treated with total knee arthroplasty, alignment with a slight femoral under-correction has advantages over the neutral alignment in terms of the shorter operative time and better short-term clinical results. Level of evidence III
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spelling doaj.art-584b2f37fcf44624ac6635bd5e1b94342022-12-21T19:49:48ZengBMCArthroplasty2524-79482022-01-01411810.1186/s42836-021-00105-4Slight femoral under-correction versus neutral alignment in total knee arthroplasty with preoperative varus knees: a comparative studyKai Lei0Li-Ming Liu1Peng-Fei Yang2Ran Xiong3De-Jie Fu4Liu Yang5Lin Guo6Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University)Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University)Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University)Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University)Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University)Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University)Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University)Abstract Background This study aimed to compare the short-term clinical results of slight femoral under-correction with neutral alignment in patients with preoperative varus knees who underwent total knee arthroplasty. Methods The medical records and imaging data were retrospectively collected from patients who had undergone total knee arthroplasty in our hospital from January 2016 to June 2019. All patients had varus knees preoperatively. Upon 1:1 propensity score matching, 256 patients (256 knees) were chosen and divided into a neutral alignment group (n=128) and an under-correction group (n=128). The patients in the neutral group were treated with the neutral alignment. In the under-correction group, the femoral mechanical axis had a 2° under-correction. The operative time, tourniquet time and the length of hospital stay in the two groups were recorded. The postoperative hip-knee-ankle angle, frontal femoral component angle and frontal tibial component angle were measured. Patient-reported outcome measures were also compared. Results The operative time, tourniquet time and the length of hospital stay in the under-correction group were significantly shorter than the neutral alignment group (P<0.05). At the 2-year follow-up, the under-correction group had a larger varus alignment (P<0.05) and a larger frontal femoral component angle (P<0.05), and the frontal tibial component angles of the two groups were comparable. Compared with the neutral alignment group, the slight femoral under-correction group had significantly better patient-reported outcome measures scores (P<0.05). Conclusion For varus knees treated with total knee arthroplasty, alignment with a slight femoral under-correction has advantages over the neutral alignment in terms of the shorter operative time and better short-term clinical results. Level of evidence IIIhttps://doi.org/10.1186/s42836-021-00105-4Total knee arthroplastyKnee replacementVarus kneeUnder-correctionMechanical alignmentAdjusted mechanical alignment
spellingShingle Kai Lei
Li-Ming Liu
Peng-Fei Yang
Ran Xiong
De-Jie Fu
Liu Yang
Lin Guo
Slight femoral under-correction versus neutral alignment in total knee arthroplasty with preoperative varus knees: a comparative study
Arthroplasty
Total knee arthroplasty
Knee replacement
Varus knee
Under-correction
Mechanical alignment
Adjusted mechanical alignment
title Slight femoral under-correction versus neutral alignment in total knee arthroplasty with preoperative varus knees: a comparative study
title_full Slight femoral under-correction versus neutral alignment in total knee arthroplasty with preoperative varus knees: a comparative study
title_fullStr Slight femoral under-correction versus neutral alignment in total knee arthroplasty with preoperative varus knees: a comparative study
title_full_unstemmed Slight femoral under-correction versus neutral alignment in total knee arthroplasty with preoperative varus knees: a comparative study
title_short Slight femoral under-correction versus neutral alignment in total knee arthroplasty with preoperative varus knees: a comparative study
title_sort slight femoral under correction versus neutral alignment in total knee arthroplasty with preoperative varus knees a comparative study
topic Total knee arthroplasty
Knee replacement
Varus knee
Under-correction
Mechanical alignment
Adjusted mechanical alignment
url https://doi.org/10.1186/s42836-021-00105-4
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