12-year functional outcome of patients undergoing Total knee replacement with Under-correction of Varus Deformity

Volume 17 | Issue 3 | July – September 2022 | Page 12-16 | Amyn M. Rajani, Kareena Rajani, Urvil A. Shah, Anmol RS Mittal, Richa Singhal

Authors: Amyn M. Rajani [1], Kareena Rajani [1], Urvil A. Shah [1], Anmol RS Mittal [1], Richa Singhal [1]

[1] Department of Orthopaedic Arthroscopic Knee and Shoulder (OAKS) Clinic, 707 Panchshil Plaza, N S Patkar Marg, opp. Ghanasingh Fine Jewels, next to Dharam Palace, Gamdevi, Mumbai, Maharashtra 400007.


Address of Correspondence

Dr. Amyn M. Rajani,

Department of Orthopaedic Arthroscopic Knee and Shoulder (OAKS) Clinic, 707 Panchshil Plaza, N S Patkar Marg, opp. Ghanasingh Fine Jewels, next to Dharam Palace, Gamdevi, Mumbai, Maharashtra 400007

E-mail: dramrajani@gmail.com



Introduction: Tricompartmental knee osteoarthritis is a common, progressively debilitating condition. Total knee replacement has been established as the best modality of treatment in such cases. With 58% of arthritic knees having a varus deformity, literature is still bleak in terms of substantial long-term follow-up studies directed towards establishing the most proficient correction technique of these deformities.

Methods: 75 consecutive knees with degenerative osteoarthritis, who underwent total knee replacement between January 2009 and December 2011 were evaluated at a mean postoperative follow-up of 12.5±1 years. All of these patients underwent uniform, monitored rehabilitation. Radiological analysis using plain radiography, and functional outcome analysis using KOOS questionnaire was done at terminal follow-up. A retrospective analysis of the nature of deformity correction or postoperative limb alignment was done using immediate post-operative radiographs. Data was compiled on the SPSS-24 software and analyzed using Welch’s t-test.

Results: The mean age of patients was 64.02 years (Range: 49-79 years). 54 (72%) female and 21 (28%) male knees were evaluated. There was no noteworthy difference between the sides of affliction, with the left knee affected in 37 (49.3%) cases, and the right knee in 38 (50.7%) cases. Patients were segregated into three groups based on retrospective radiological analysis of postoperative femorotibial alignment, namely Varus (nv=59, mean varus=2.03o), Rectus (nr=5), and Valgus (ng=11, mean valgus=1.55o). The varus group had statistically insignificant (p>0.05), albeit better mean KOOS than the rectus and valgus groups (92.8 vs 92 vs 91.36) at terminal follow-up. A higher number of cases were able to kneel, and sit cross-legged in the varus group. There was no radiological sign of implant loosening or need for revision in any of the observed cases, irrespective of the group.

Conclusion: At a mean 12.5-year follow-up, patients who underwent under-correction of varus deformity had a favorable functional outcome and were able to carry out all the functional activities including the ability to sit cross-legged and kneel as adeptly as their counterparts. There was no sign of radiological complication in any case. Hence, under-correction of varus deformity during Total knee replacement provides excellent long-term functional, radiological, and implant related outcomes.

Keywords: Long-term, under-correction, varus, TKR, KOOS


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How to Cite this article: Rajani AM, Rajani K, Shah UA, Mittal ARS, Singhal R. 12-year functional outcome of patients undergoing Total knee replacement with Under-correction of Varus Deformity. Journal of Trauma and Orthopaedic Surgery July-Sep 2022;17(3): 12-16.

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