The correction of severe varus deformity in total knee arthroplasty by tibial component downsizing and resection of uncapped proximal medial bone

The clinical and radiologic outcome of 10 patients (12 knees) with a mean varus deformity of 24degrees (range, 20degrees to 40degrees) treated with total knee arthroplasty (TKA) is presented. We describe a technique of downsizing and lateralizing the tibial component with subsequent removal of the proximal medial tibia flush with the downsized component. At a mean follow-up of 42 months (range, 12 to 64 months), the mean preoperative Knee Society and function scores had improved from 24 and 34 to 94 and 85, respectively, at follow-up. No implant has been revised. At follow-up evaluation, no evidence of osteolysis or radiographic loosening was seen and the mean tibiofemoral angle was 4degrees of valgus. This technique provides mid-term stable correction and excellent clinical and radiographic results in patients with severe varus deformity.