{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:22:11Z","timestamp":1783488131377,"version":"3.55.0"},"reference-count":43,"publisher":"Georg Thieme Verlag KG","issue":"07","license":[{"start":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T00:00:00Z","timestamp":1724112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>When performing caliper-verified kinematically aligned total knee arthroplasty (KA TKA) in the osteoarthritic (OA) knee with valgus deformity, an elongated medial collateral ligament (MCL) could result in a valgus setting of the tibial component. The present study analyzed KA TKA in patients with valgus deformities (i.e., tibiofemoral angle\u2009&gt;\u200910\u2009degrees of valgus) and determined (1) the occurrence of radiographic MCL elongation, (2) the incidence of lateral collateral ligament (LCL) and posterior cruciate ligament (PCL) release and the use of constrained components, and (3) whether the 1-year Forgotten Joint Score (FJS), Oxford Knee Score (OKS), Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS JR), and Likert satisfaction score were comparable to KA TKAs for OA deformities \u226410\u2009degrees of valgus. One hundred and two consecutive patients who underwent KA TKA by a single surgeon were analyzed radiographically and clinically at a minimum follow-up of 1 year. Radiographic MCL elongation was identified by a greater than 1\u2009degree of valgus orientation of the tibial component relative to the OA tibial joint line. Twenty-six patients had a radiographic anatomic tibiofemoral angle greater than 10\u2009degrees of valgus (range of OA deformity: 11\u201323\u2009degrees of valgus). Seventy-six had an OA deformity \u226410\u2009degrees of valgus (10-degree valgus to \u201314-degree varus). No patient had MCL elongation or a ligament release, or required constrained components. The median FJS of 78, OKS of 42, and KOOS JR of 76, and the 85% satisfaction rate of the patients with greater than 10\u2009degrees of OA valgus deformity were not significantly different from those with \u226410\u2009degrees of OA valgus deformity (p \u2265 0.17). Because MCL elongation was not detected in OA deformities up to 23\u2009degrees of valgus, the risk of under-correcting the valgus deformity leading to instability and poor outcome scores is low when performing KA TKA using primary components without releasing the LCL and\/or PCL.<\/jats:p><jats:p>\n               Level of Evidence:\u2003IV.<\/jats:p>","DOI":"10.1055\/a-2395-6831","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T04:47:20Z","timestamp":1724302040000},"page":"328-335","source":"Crossref","is-referenced-by-count":2,"title":["No Radiographic Evidence of Medial Collateral Ligament Elongation in Valgus Osteoarthritic Knees Enables Treatment with Kinematically Aligned Total Knee Arthroplasty"],"prefix":"10.1055","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3655-158X","authenticated-orcid":false,"given":"Alexander J.","family":"Nedopil","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, K\u00f6nig-Ludwig-Haus, University of W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand Singh","family":"Dhaliwal","sequence":"additional","affiliation":[{"name":"College of Medicine, California Northstate University, Elk Grove, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0819-4706","authenticated-orcid":false,"given":"Antonio","family":"Klasan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, AUVA UKH Steiermark, Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8184-0324","authenticated-orcid":false,"given":"Stephen M.","family":"Howell","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, University of California at Davis, Davis, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8305-4589","authenticated-orcid":false,"given":"Maury L.","family":"Hull","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, University of California at Davis, Davis, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,9,27]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1007\/s00264-013-2227-4","article-title":"Total knee arthroplasty in the valgus knee","volume":"38","author":"R Rossi","year":"2014","journal-title":"Int Orthop"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1097\/01.blo.0000092987.12414.fc","article-title":"The difficult knee: severe varus and valgus","volume":"416","author":"G A Engh","year":"2003","journal-title":"Clin Orthop Relat Res"},{"issue":"S 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limb and joint line alignment after kinematically aligned total knee arthroplasty","volume":"99-B","author":"T J Shelton","year":"2017","journal-title":"Bone Joint J"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.jbiomech.2017.05.008","article-title":"Contact forces in the tibiofemoral joint from soft tissue tensions: implications to soft tissue balancing in total knee arthroplasty","volume":"58","author":"M A Verstraete","year":"2017","journal-title":"J Biomech"},{"issue":"03","key":"ref40","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1007\/s00167-021-06473-3","article-title":"Reoperations are few and confined to the most valgus phenotypes 4 years after unrestricted calipered kinematically aligned TKA","volume":"30","author":"S M Howell","year":"2022","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"05","key":"ref41","doi-asserted-by":"crossref","first-page":"778","DOI":"10.3390\/jpm13050778","article-title":"Influence of mechanical alignment on functional knee phenotypes and clinical outcomes in primary TKA: a 1-year prospective analysis","volume":"13","author":"D Rak","year":"2023","journal-title":"J Pers Med"},{"issue":"12","key":"ref42","doi-asserted-by":"crossref","first-page":"5319","DOI":"10.1007\/s00167-023-07576-9","article-title":"Setting the distal and posterior condyle of the femoral component to restore the medial pre-arthritic femoral articular surface results in better outcomes after total knee arthroplasty","volume":"31","author":"D Rak","year":"2023","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"12","key":"ref43","doi-asserted-by":"crossref","first-page":"2287","DOI":"10.1007\/s00402-021-04054-0","article-title":"An insert with less than spherical medial conformity causes a loss of passive internal rotation after calipered kinematically aligned TKA","volume":"141","author":"A J Nedopil","year":"2021","journal-title":"Arch Orthop Trauma Surg"},{"issue":"20","key":"ref44","doi-asserted-by":"crossref","first-page":"e883","DOI":"10.5435\/JAAOS-D-23-00586","article-title":"Patient-reported outcome measures: state of the art in patient-reported outcome measure application in lower extremity orthopaedics","volume":"31","author":"I Pasqualini","year":"2023","journal-title":"J Am Acad Orthop Surg"}],"container-title":["The Journal of Knee Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2395-6831.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T23:19:38Z","timestamp":1749251978000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2395-6831"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,20]]},"references-count":43,"journal-issue":{"issue":"07","published-online":{"date-parts":[[2025,5,21]]},"published-print":{"date-parts":[[2025,6]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2395-6831","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1538-8506","1938-2480"],"issn-type":[{"value":"1538-8506","type":"print"},{"value":"1938-2480","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,8,20]]},"published":{"date-parts":[[2024,8,20]]}}}