An Algorithmic Approach to Total Knee Arthroplasty in the Valgus Knee

The valgus arthritic knee presents as a complex deformity characterized by bone loss involving the lateral femoral condyle, contractures of the lateral soft-tissue structures, and concomitant instability. Patients with end-stage degenerative joint disease and valgus knee deformity have pain, limitation of activities of daily living, increasing angular deformity, and increasing instability. Total knee arthroplasty with valgus release is indicated when both mechanical and pharmacological nonoperative treatment modalities for end-stage degenerative joint disease have failed to relieve pain. The major contraindication to total knee arthroplasty is infection, and relative contraindications include young age, high activity level, and obesity.