Total Knee Arthroplasty in Severe Valgus Osteoarthritis Excellent Early Results in a 90-Year-Old Patient with a Valgus Deformity of 47°

Abstract EN

Grade III valgus deformity (tibiofemoral alignment > 20°) is present in only 0.5% of patients receiving total knee arthroplasty.

Furthermore, cases with a valgus deformity exceeding 40° are even rarer.

Since they mostly affect elderly, polymorbid patients, successful outcome means a great challenge.

We report on a case of a 90-year-old patient with a valgus deformity of 47°.

The patient was preoperatively restricted to a wheel chair, unable to walk, and only able to stand for a few seconds.

The maximal knee flexion was 100°, and there was an extension deficit of 15°.

The WOMAC score was 91; the EQ-5D-5L Index was 0.048.

She was treated with a constrained hinged prosthesis.

Postoperatively, the axis was 6° valgus.

After 3 months of rehabilitation, she was independent using a wheeled walker.

The maximal flexion of the knee was 110° and there was no extension deficit.

The WOMAC score was 45; the EQ-5D-5L Index was 0.813.

This case demonstrates the possibility of a satisfactory result and an improvement in quality of life and mobility with a plausible timetable and with reasonable use of resources even in advanced age and severe valgus deformity.