Total Knee Replacement in the Varus Knees: What Measurement really matters Introducing a new classification system

BackhroundsTKA is one of the surgeries that has a high level of satisfaction in patients and can greatlyimprove the patients› function and life style. One of the most important factors in increasingthe outcome of patients is appropriate preoperative planning. Varus deformity is one of thechallenges in many patients before TKA, and in various studies, different surgical techniqueshave been proposed. Our purpose in this study is to present a new classification and surgicaltechnique patients with Varus deformity Candidate for total knee replacement.MethodsIn this study, 81 patients (including 81 knees) were studied. %68 of patients were femaleand the rest were male. After the initial pre-op planning, Patients were operated based on the medial defect and lateral laxity (opening the lateral of knee more than 5 mm and/or lateral trust) and finally classified. Then cut-off size of the lateral tibia was determinedbased on new classificationResultsIn the present study, Varus varies in the range of 9 to 42 degrees. According to the newclassification system, 13 % of patients were in type 1 (without defect -without laxity) , 18 %in type 2 ( without defect - with laxity) ,.27 % in type 3( with defect - without laxity) , 42 % intype 4 ( with defect - with laxity) . 13 % of patients needed medial release. all patients wereplaced under the TKA with PS system. The size of the liner in %78 of patients was 10 mm,8 ,%17 mm and other were larger sizesConclusionsAccording to the analysis, in patients with same JCA and same lateral trust, those withoutbony defect will need more medial soft tissue release. So, we suggested in those patients,lateral tibial cut should be minimally.