{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:45:04Z","timestamp":1792622704896,"version":"4.5.0"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2013,1,16]],"date-time":"2013-01-16T00:00:00Z","timestamp":1358294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The objective of this study was to compare the outcome of constrained and unconstrained primary total knee arthroplasty (TKA) in the management of the valgus deformity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective review of patients with type II valgus knee who underwent primary TKA from 1999 to 2011. There were fifty patients in Group 1 who underwent varus\u2013valgus constrained TKA. They were matched with another fifty patients in Group 2 who underwent unconstrained TKA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean joint line shift was significantly higher in Group 1 (+8\u00a0mm, SD 6\u00a0mm) than in Group 2 (+2\u00a0mm, SD 3\u00a0mm) (<jats:italic>p<\/jats:italic> = 0.03). At 2 years, there was no difference in anterior\u2013posterior stability and mediolateral stability according to the Knee Society Score, and patients in Group 2 reported significantly better mean function score of 66.2 (SD 9.3) (mean 48, SD 7.1\u00a0in Group 1) (<jats:italic>p<\/jats:italic> = 0.002). Two patients (6 %) in Group 1 underwent revision surgery\u2014one for a broken central peg and the other for aseptic loosening. Three patients (2 %) in Group 2 underwent revision surgery\u2014two for global instability and one for poly wear. The estimated survivorship time was 8.3 years for constrained TKA and 12.0 for unconstrained TKA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Constrained TKA was associated with more significant joint line changes for the management of valgus arthritic knee, when compared with unconstrained TKA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Retrospective study, Level III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-013-2390-6","type":"journal-article","created":{"date-parts":[[2013,1,15]],"date-time":"2013-01-15T09:11:08Z","timestamp":1358241068000},"page":"2363-2369","source":"Crossref","is-referenced-by-count":36,"title":["Joint line changes and outcomes in constrained versus unconstrained total knee arthroplasty for the type II valgus knee"],"prefix":"10.1002","volume":"21","author":[{"given":"Hee\u2010Nee","family":"Pang","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Singapore General Hospital 1 Outram Road 169608 Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seng\u2010Jin","family":"Yeo","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Singapore General Hospital 1 Outram Road 169608 Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hwei\u2010Chi","family":"Chong","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Singapore General Hospital 1 Outram Road 169608 Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pak\u2010Lin","family":"Chin","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Singapore General Hospital 1 Outram Road 169608 Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi\u2010Lu","family":"Chia","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Singapore General Hospital 1 Outram Road 169608 Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ngai\u2010Nung","family":"Lo","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Singapore General Hospital 1 Outram Road 169608 Singapore 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