2023, Vol. 27 ›› Issue (13): 2033-2037

Mid- and long-term follow-up of valgus knees with total knee arthroplasty via subvastus approach

Liu Hongwen1, 2, Yin Li3, Xu Wenhao3, Li Jiao3, Luo Fenqi2, Liu Shaojiang1, Xu Jie2   

Abstract: BACKGROUND: The subvastus approach is the most minimally invasive surgical method for total knee arthroplasty. The knee joint function recovers quickly after surgery, but the long-term efficacy is unclear.  
OBJECTIVE: To evaluate the mid- and long-term prosthesis position and knee function of valgus knees with total knee arthroplasty via subvastus approach.
METHODS:   A retrospective investigation was conducted among 50 patients (55 knees) with valgus knees in the Department of Orthopedics, Fujian Provincial Hospital from January 2009 to January 2018. Total knee arthroplasty was performed via subvastus approach, femoral distal resection with 3°to 5°of valgus, and the routinely resurfaced patella. The operation time, blood loss, incision length, grounding time, time up and downstairs, and hospital stay were recorded. Visual analogue scale, Knee Society Score, hospital for special surgery, range of motion, femorotibial angle, hip-knee-ankle angle, condylar-hip angle, and plateau-ankle angle were counted to assess postoperative efficacy and prosthesis position.  
RESULTS AND CONCLUSION: (1) Follow-up time was 5.7-11.1 years. (2) The operation time was (67.2±6.2) minutes; blood loss was (317.3±109.6) mL; incision length was (11.5±1.2) cm; grounding time was (1.1±0.5) days; time of up and down stairs was (2.3±0.9) days; hospital stay was (4.9±1.2) days. (3) Compared with preoperative data, visual analogue scale scores decreased significantly. Range of motion, Knee Society Score, and hospital for special surgery score increased significantly at the last follow-up. Femorotibial angle / hip-knee-ankle angle decreased significantly. Condylar-hip angle and plateau-ankle angle decreased significantly (P < 0.001). (4) No postoperative complications such as common peroneal nerve palsy, infection or deep venous embolism occurred. During the follow-up, the prosthesis was in a good position and no revision cases were performed. (5) It is indicated that total knee arthroplasty via subvastus approach for valgus knees can get satisfactory mid- and long-term prosthesis position, lower limb alignment, and functional recovery.
Key words: subvastus approach, arthroplasty, valgus knees, prosthesis position, clinical outcome