Valgus Patients Would Benefit More Than Varus Patients From Total Knee Arthroplasty

Background: There is no consensus regarding the effect of the type of deformities (valgus or varus) on the functional outcome of total knee arthroplasty (TKA). We aimed to compare the TKA outcome in varus and valgus patients to find whether different angulations of the knee could affect the functional outcome of the TKA. Methods: In total, 55 valgus and 53 varus osteoarthritic knees with matched age, gender, BMI, tibiofemoral angle, comorbidities, type of prosthesis, and follow-up duration were included in the study. The mean follow-up of patients was 4.5 ± 1.7 years. The knee society score (KSS) was calculated for each knee at the latest follow-up. In addition, the western Ontario and McMaster Universities arthritis index (WOMAC) was assessed for each patient several times during the study in order to monitor the course of treatment. Results: The total KSS was significantly higher in varus knees than in valgus knees, with the values of 82.80 ± 10.16 versus 78.61 ± 10.7, respectively (P = 0.023). Varus patients had a significantly better preoperative WOMAC index than valgus patients (with a score of 51.2 ± 4.05 vs. 42.21 ± 4.12) (P = 0.012). At the final follow-up, varus patients still had superior WOMAC although this difference was not statistically significant (P = 0.722). Interestingly, the WOMAC change in the first and final evaluations was significantly different in the two study groups, with 22.06 in varus and 30.14 in valgus patients (P 0.001). Conclusions: According to our results, the type of deformity could affect the long-term TKA outcome. In this regard, valgus patients would benefit more than varus patients from this surgery.