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Postoperative Alignment of Total Knee Replacement Its Effect on Survival
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1994
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421 posterior cruciate condylar total knee arthroplasties were performed between 1975 and 1983, with postoperative anatomic alignment recorded up to 13 years and patients grouped into normal (5–8° valgus), varus (≤4° valgus to any varus), and valgus (>9° valgus) categories. Survival analysis revealed no failures in the valgus group, five failures in the varus group and three in the normal group, with Kaplan–Meier curves showing no significant difference between normal and valgus but a statistically significant difference when compared to varus, supporting alignment in neutral or slight valgus for optimal long‑term survival.
Four hundred twenty-one posterior cruciate condylar total knee arthroplasties were performed between 1975 and 1983. Anatomic alignment of the knee was recorded on follow-up evaluations from two months to 13 years postoperatively. Patients were stratified into a normal group that was 5° to 8° anatomic valgus, a varus group that was from 4° anatomic valgus to any degree of varus, and a valgus group that was more than 9° anatomic valgus. There were eight failures, five in the varus group and three in the normal group. There were no failures in the valgus group. Kaplan-Meier survival curves showed no significant difference between normal and valgus groups; however, there was a statistical difference between the valgus and varus and the normal and varus groups. A surgeon should align a total knee prosthesis in neutral or a slight amount of anatomic valgus to give the patient the best chance for long-term survival.