Balancing severe valgus deformity in total knee arthroplasty using a lateral cruciform retinacular release

We report the technique and results of a cruciform lateral release performed on 35 consecutive knees having ≥15° of valgus with minimum 2-year follow-up. The posterior cruciate ligament (PCL) was preserved in all knees. Preoperative valgus averaged 17°, and range of motion averaged 10° to 107°. Postoperative valgus averaged 4.8°, and average postoperative range of motion was 2° to 110°. The PCL was partially released in 5 knees, and further lateral release of the lateral collateral ligament and popliteus were required in 3 knees. Stable flexion and extension gaps were achieved in all cases, and stability was maintained at follow-up. This lateral cruciform retinacular release provides a simple surgical technique for most valgus deformities of the knee and allows for stable ligamentous balancing.