Total arthroplasty in valgus knee: an update in the robotics era

摘要

Total knee arthroplasty can be a complex procedure, especially in the presence of valgus knee deformity, which poses significant challenges in terms of soft tissue balancing and implant alignment. This study aims to delineate the intricacies of managing valgus deformities in total knee arthroplasty, highlighting the role of robotic-assisted techniques. In detail, the paper presents anatomical and biomechanical considerations unique to the valgus knee, the importance of thorough clinical and radiographic evaluation, classifications of valgus deformity, and the implications for implant choice and surgical approaches. It underscores the necessity of precise bone cuts and alignment to ensure the success of the procedure and the significance of meticulous soft tissue release to achieve knee stability and optimal functional outcomes. This review explores the complex aspects of surgery, including the use of robotic systems which have shown promise in improving the accuracy of implant placement and alignment, a critical factor in the longevity and functionality of total knee arthroplasty implants. It describes the authors’ technique in the robotics era, emphasizing preoperative planning, intraoperative assessments, and postoperative rehabilitation. This comprehensive approach to total knee arthroplasty in valgus knees provides an outline for achieving neutral alignment, gap balancing, and stability, which are crucial for successful patient outcomes. The study concludes that the integration of modern robotics, combined with a deep understanding of knee deformity correction, implant selection, and soft tissue management, is revolutionizing total knee arthroplasty, making it a safer and more reproducible technique, even in severe valgus deformities associated with osteoarthritis.