The Open Orthopaedics Journal

ISSN: 1874-3250 ― Volume 13, 2019

Clinical Outcomes of Patients with Valgus Deformity Undergoing Minimally Invasive Total Knee Arthroplasty Through the Medial Approach

Kosuke Hamahashi1, *, Genya Mitani2, Tomonori Takagaki1, 3, Kenji Serigano1, Joji Mochida1, 3, Masato Sato1, Masahiko Watanabe1
1 Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, Kanagawa, Japan
2 Department of Orthopaedic Surgery, Tokai University Oiso Hospital, Kanagawa, Japan
3 Division of Orthopaedic Surgery, Ebina General Hospital, Kanagawa, Japan



The purpose of this study was to compare the clinical outcomes between patients with a valgus or varus deformity undergoing minimally invasive total knee arthroplasty through the medial approach.


The patients were classified into 2 groups according to the preoperative femorotibial angle measured on an anteroposterior long leg roentgenogram. The valgus group comprised of 26 knees in 21 patients with a femorotibial angle <170° (163.5 ± 5.7), and the varus group comprised of 24 knees in 21 patients with a femorotibial angle >190° (195.9 ± 5.5). The following background variables were compared between the groups: age at the time of the operation, sex, causative disease, preoperative femoral mechanical–anatomical angle, and postoperative knee range of motion, Knee Society score, femorotibial angle, and implant position.


There were significant differences between the valgus and varus groups in the age (68.0 ± 6.9 vs 75.8 ± 6.2 years), percentage of males (23.8% vs 0%), percentage with rheumatoid arthritis (61.9% vs 4.8%), and preoperative femoral mechanical–anatomical angle (6.2 ± 1.0° vs 7.4 ± 2.1°). Clinical outcome variables of postoperative femorotibial angle (173.1 ± 3.9° vs 175.2 ± 1.6°) and α angle (96.6 ± 3.1° vs 95.0 ± 1.9°) also differed.


It was assumed that over-valgus resection of the femur is a contributory factor to residual valgus alignment. However, knee range of motion and Knee Society score did not differ between the groups. We suggest that minimally invasive total knee arthroplasty through the medial approach is one of the treatment options for patients with valgus deformity.

Keywords: Femoral Mechanical‒Anatomical Angle, Medial Approach, Minimally Invasive Total Knee Arthroplasty, Pie Crust Technique, Posterior-Stabilized Implant, Valgus Deformity.

Article Information

Identifiers and Pagination:

Year: 2016
Volume: 10
First Page: 717
Last Page: 724
Publisher Id: TOORTHJ-10-717
DOI: 10.2174/1874325001610010717

Article History:

Received Date: 06/10/2016
Revision Received Date: 18/11/2016
Acceptance Date: 23/11/2016
Electronic publication date: 21/12/2016
Collection year: 2016

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© Hamahashi et al.; Licensee Bentham Open

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan; Tel: +81-463-93-1121; Fax: +81-463-96-4404; E-mail:


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