Tightening medial collateral ligament during total knee arthroplasty for patients with fixed valgus deformity: A novel technique

Background: This study aimed to explore a new surgical technique for gap balance by tightening the medial collateral ligament (MCL) in total knee arthroplasty (TKA) in patients with fixed valgus deformity. Materials and Methods: A prospective analysis was performed on 15 patients (16 knees) with a fixed valgus deformity that was corrected by tightening the MCL during TKA. A single surgeon performed all the 16 TKAs using nonconstrained posterior substituting implant, with two knees treated with long-stem tibial prosthesis. Clinical scores, knee stability, and radiographic evaluations were recorded preoperatively and postoperatively. Results: Complete weight-bearing could be carried out under the protection of the brace postoperatively. At the third month after surgery, X-rays showed the brace was not worn. The mean follow-up was 26.6 months (range 12-42 months). The average preoperative mechanical axis was 15.4 +/- 2.3 degrees (range 11-25 degrees), and postoperatively it was 0.6 +/- 0.1 degrees (range 0-2 degrees). No complication relative to the technique occurred. Conclusion: This new surgical technique has demonstrated excellent early clinical results and can be a good supplement for fixed valgus knee arthroplasty.