Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
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

Affiliations
Review

Varus-valgus constrained implants in total knee arthroplasty: indications and technique

Paolo Adravanti et al. Acta Biomed. .

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.

PubMed Disclaimer

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

References

    1. Abdel MP, Pulido L, Severson EP, Hanssen AD. Stepwise surgical correction of instability in flexion after total knee replacement. The bone & joint journal. 2014;96-B(12):1644–8. doi:10.1302/0301-620X.96B12.34821. - PubMed
    1. Anderson JA, Baldini A, MacDonald JH, Pellicci PM, Sculco TP. Primary constrained condylar knee arthroplasty without stem extensions for the valgus knee. Clinical orthopaedics and related research. 2006;442:199–203. - PubMed
    1. Anderson JA, Baldini A, MacDonald JH, Tomek I, Pellicci PM, Sculco TP. Constrained condylar knee without stem extensions for difficult primary total knee arthroplasty. The journal of knee surgery. 2007;20(3):195–8. - PubMed
    1. Barrack RL. Rise of the rotating hinge in revision total knee arthroplasty. Orthopedics. 2002;25(10):1020, 1058. - PubMed
    1. Bass AR, McHugh K, Fields K, Goto R, Parks ML, Goodman SM. Higher Total Knee Arthroplasty Revision Rates Among United States Blacks Than Whites: A Systematic Literature Review and Meta-Analysis. The Journal of bone and joint surgery American volume. 2016;98(24):2103–8. doi:10.2106/JBJS.15.00976. - PubMed

LinkOut - more resources