Correcting varus and valgus knee in total knee arthroplasty (TKA)

Correction of severe varus and valgus deformity in TKA requires a clear understanding of the location, orientation and biomechanical functions of the soft-tissue structures that provide stability to the knee. Correct ligament balancing in TKA allows for satisfactory knee proprioception, restores proper load transfer and theoretically improves implant survivorship. This chapter describes a stepwise approach to correcting varus and valgus deformity in TKA. When the deformity is fixed and not reducible, correction is more difficult to achieve. Significant varus or valgus malalignment on the coronal plane is very often associated with sagittal plane and torsional deformities: these deformities should be globally addressed in order to avoid a residual degree of deformity.