Comparison of computer-navigated and conventional total knee arthroplasty in patients with Ranawat type-II valgus deformity: medium-term clinical and radiological results

Background: Arthritic knees with Ranawat type-II valgus deformity present with soft tissue contracture and osseous anomalies that make total knee arthroplasty (TKA) difficult. We hypothesized that computer-navigated-TKA (CN-TKA) may be superior to conventional techniques and provide better mid-term radiographic and clinical outcomes in such cases. Methods: Between January 2002 and January 2009, patients with Ranawat type-II valgus deformity who underwent primary TKA were entered into this retrospective study. Conventional TKA and CN-TKA were compared for the accuracy of component placement, joint line level, and postoperative limb alignment. International Knee Society scores and patellar scores were used for clinical assessment. Results: A total of 62 patients (70 knees) with a minimum of 5 years of follow-up were studied. Conventional TKA was performed in 36 knees and CN-TKA in 34 knees. A significantly higher rate of lateral retinaculum release was recorded in the conventional TKA group compared to the CN-TKA group. Proper restoration of joint line was achieved using CN-TKA. The range of motion of the knees was similar in both groups preoperative and postoperatively. There were no significant differences in reconstructed mechanical axes, accuracy of component positioning, and difference in perioperative hemoglobin level between the two groups. At a mean follow-up of 6.2 years, both groups had significant postoperative improvements in clinical performance, however the difference did not reach statistical significance between both techniques. Conclusions: Our findings demonstrate that CN-TKA can properly restored the joint line level for arthritic knees with Ranawat type II valgus deformity. However, no differences in clinical function, limb and component alignment, or survival of the prostheses were noted between the CN-TKA and conventional TKA groups at a mean follow-up of 6.2 years.