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Review
. 2017 Jun 7;88(2S):112-117.
doi: 10.23750/abm.v88i2-S.6521.

Varus-valgus Constrained Implants in Total Knee Arthroplasty: Indications and Technique

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Free PMC article
Review

Varus-valgus Constrained Implants in Total Knee Arthroplasty: Indications and Technique

Paolo Adravanti et al. Acta Biomed. .
Free PMC article

Abstract

Total knee arthroplasty is a successful operation that significantly improves patient's quality of life. However, studies demonstrated as only 82% to 89% of patients are satisfied with their surgery, being the other disappointed with regard to their expectations. Two to 5.7% of total knee arthroplasties (TKAs) require revision within 5 years. Both complex primary cases and revision TKA often necessitate for a higher degree of constrain than cruciate retaining or postero-stabilized implant design. In the 1970s varus-valgus constrained (VVC) or semi-constrained implants have been developed by Insall and associates from the PS design, which provide varus-valgus stability preserving a fair amount of host bone. VVC TKAs allows for a small amount of movement in the coronal, antero-posterior and axial planes. In this paper, the authors give an overview of the indications, outcomes and technique for varus-valgus constrained implants, both in the setting of primary and revision knee arthroplasty.

Keywords: TKA; constrained non-linked; semi-constrained; varus-valgus constrained.

Figures

Figure 1.
Figure 1.
AP and Lateral x-rays, right knee. Severe valgus knee addressed with VVC implant type without stems (LCCK, NexGen, Zimmer). Since the MCL was insufficient, it was firstly attempted its repair with a small joint anchor on the medial tibial plateau. However, the surgeon was not completely satisfied with the valgus stability, therefore he switched from a PS to a VVC implant, with a CCK type polyethylene and no stems
Figure 2.
Figure 2.
AP and Lateral x-rays, right knee. VVC implant type with stems (LCCK, NexGen, Zimmer). Although it was a revision TKA, the varus-valgus stability was found to be optimal, therefore a PS type polyethylene was used

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