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Case Reports in Orthopedics
Volume 2017, Article ID 9301017, 5 pages
https://doi.org/10.1155/2017/9301017
Case Report

Total Knee Arthroplasty in Severe Valgus Osteoarthritis Excellent Early Results in a 90-Year-Old Patient with a Valgus Deformity of 47°

1Department of Orthopedic Surgery, University Hospital of Basel, Spitalstrasse 21, 4056 Basel, Switzerland
2Clinic for Orthopedics “Claraortho”, Claragraben 82, 4058 Basel, Switzerland

Correspondence should be addressed to Petros Ismailidis; moc.liamg@sidiliamsisortep

Received 27 November 2016; Accepted 19 February 2017; Published 12 March 2017

Academic Editor: Werner Kolb

Copyright © 2017 Petros Ismailidis et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Grade III valgus deformity (tibiofemoral alignment > 20°) is present in only 0.5% of patients receiving total knee arthroplasty. Furthermore, cases with a valgus deformity exceeding 40° are even rarer. Since they mostly affect elderly, polymorbid patients, successful outcome means a great challenge. We report on a case of a 90-year-old patient with a valgus deformity of 47°. The patient was preoperatively restricted to a wheel chair, unable to walk, and only able to stand for a few seconds. The maximal knee flexion was 100°, and there was an extension deficit of 15°. The WOMAC score was 91; the EQ-5D-5L Index was 0.048. She was treated with a constrained hinged prosthesis. Postoperatively, the axis was 6° valgus. After 3 months of rehabilitation, she was independent using a wheeled walker. The maximal flexion of the knee was 110° and there was no extension deficit. The WOMAC score was 45; the EQ-5D-5L Index was 0.813. This case demonstrates the possibility of a satisfactory result and an improvement in quality of life and mobility with a plausible timetable and with reasonable use of resources even in advanced age and severe valgus deformity.