{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T11:14:38Z","timestamp":1791285278127,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Postoperative instability represents one of the most common complications following primary total knee arthroplasty (TKA). To prevent this outcome, valgus deformities have been historically treated using more constrained implants. The purpose of this study was to evaluate the outcome of treating a moderate valgus deformity by combining a surgical technique used to release the postero\u2010lateral soft tissue envelope with the use of a medially congruent (MC) TKA design without using classical, semi\u2010constrained inserts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Seventy\u2010nine MC TKAs were performed by three surgeons at three institutions between 2016 and 2018 as part of a multicenter, international study. Inclusion criteria were: radiographic late\u2010stage osteoarthritic knees with Ranawat\u2019s type 1 or 2 classification of valgus deformity and integrity of the medial capsular\u2013ligament complex (less than 10\u00a0mm of medial opening during valgus stress test at 10\u00b0 of knee flexion). Exclusion criteria were: BMI\u2009&gt;\u200940; neuromuscular, metabolic, or immunologic disorders; or the inability to complete outcome measures or radiographic assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010seven patients (79\u00a0knees), 59\u00a0males and 18 females, were evaluated at 2\u2010year minimum follow\u2010up according to the Knee Society Score (KSS) and Forgotten Joint Score (FJS). Mean age at surgery was 70 years (range 48\u201391). The mean range of motion (ROM) improved from 110\u00b0 (range 85\u00b0\u2013130\u00b0) preoperatively to 121\u00b0 (range 105\u00b0\u2013135\u00b0) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) at the time of the last follow\u2010up. Preoperative knee extension significantly improved from 3\u00b0 (range \u2212 15\u00b0 to 20\u00b0) to 1\u00b0 (range \u2212 5\u00b0 to 5\u00b0) of flexion at the last follow\u2010up in all the patients. KSS and KSS Functional scores were 89 (range 65\u2013100) and 82 points (range 55\u2013100), respectively. The FJS obtained at the last follow\u2010up was 72 (range 49\u201388). Two patients (2.5%) had major postoperative complications (one periprosthetic joint infection; one postoperative patellar fracture) requiring surgical interventions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In different surgeon\u2019s hands, the use of a modern medially congruent TKA design yielded good clinical outcomes at 2 years in a consecutive series of TKA in valgus arthritic knees. Postoperative instability was not recorded in this series and this finding was related to the high conformity design of the MC polyethylene insert, which significantly differs from classical posterior\u2010stabilized (PS) designs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-021-06754-x","type":"journal-article","created":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T03:12:42Z","timestamp":1633057962000},"page":"407-412","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Medially congruent total knee arthroplasty in valgus knee deformities yields satisfactory outcomes: a multicenter, international study"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4752-8027","authenticated-orcid":false,"given":"Pier Francesco","family":"Indelli","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Stanford University and PAVAHCS, Surgical Services Stanford University School of Medicine 94304 Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Spinello","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences \u201cSapienza\u201d University of Rome, Policlinico Umberto I Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karlos","family":"Zepeda","sequence":"additional","affiliation":[{"name":"<!--<label>6<\/label>--> Touro College of Osteopathic Medicine New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Campi","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Orthopaedic and Trauma Department Campus Biomedico University of Rome Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano Marco Paolo","family":"Rossi","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> Sezione di Chirurgia Protesica a Indirizzo Robotico, Unit\u00e0 di Traumatologia dello Sport, UOC Ortopedia e Traumatologia e Universita\u2019 degli Studi di Pavia Fondazione Poliambulanza Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Engl","sequence":"additional","affiliation":[{"name":"<!--<label>5<\/label>--> Divisione di Ortopedia Ospedale di Vipiteno Sterzing Vipiteno Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco","family":"Papalia","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Orthopaedic and Trauma Department Campus Biomedico University of Rome Rome 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