Lateral epicondyle osteotomy for correction of valgus deformity during total knee arthroplasty: Surgical technique and clinical outcomes

Background

Lateral epicondyle osteotomy is one of the surgical choices when seeking a proper equalization and balance of the flexion and extension gaps during the correction of a valgus knee deformity, when performing a total knee arthroplasty (TKA). However, its use is not frequent, and the reports described in literature are scarce. The aim of this study was to describe the clinical outcomes of the patients in which lateral epicondyle osteotomy was performed during TKA in a consecutive group of patients with valgus deformity.

Methods

Retrospective study of 18 patients with valgus deformity, who had lateral epicondyle osteotomy during TKA, from January 2016 to December 2018. The type of valgus deformity was assessed with Ranawat’s classification. The femorotibial angle was measured with a panoramic leg standing X-rays before and after the TKA; The function was evaluated with the Knee Society Score-KSS and Oxford Knee Score scale.

Results

The average age was 71.8 ± 6.1 years and 13 cases were women. According to Ranawat’s classification, 11 knees had Grade III (>20°) valgus deformity. The mean preoperative and postoperative femorotibial angles were 25.8° ± 9.9° and 7.1° ± 1.8°, respectively. Functional improvement was observed through the KSS and Oxford scales, with an average increase of 37.4 ± 13.4 and 32.4 ± 6.7 points compared to preoperative. No evidence of intraoperative or postoperative complications associated with the procedure was found.

Conclusion

In these patients, the osteotomy of the lateral epicondyle proved to be an effective surgical option for the correction of valgus deformity during TKA, allowing proper alignment of the limb with good functional results.