Knee Surg Relat Res 2019 Mar; 31(1): 12-18  https://doi.org/10.5792/ksrr.18.033
Preoperative Varus-Valgus Stress Angle Difference Is Valuable for Predicting the Extent of Medial Release in Varus Deformity during Total Knee Arthroplasty
O-Sung Lee, MD1, Ashraf Elazab, MD2,3, and Yong Seuk Lee, MD3
1Department of Orthopaedic Surgery, Mediplex Sejong Hospital, Incheon, Korea; 2Department of Orthropaedic Surgery, Dammam Medical Complex, Dammam, Saudi Arabia; 3Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
Correspondence to: Yong Seuk Lee, MD Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea Tel: +82-31-787-7199, Fax: +82-31-787-4056 E-mail: smcos1@hanmail.net
Received: May 22, 2018; Revised: October 24, 2018; Accepted: November 15, 2018; Published online: March 1, 2019.
© Korean Knee Society. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: The purpose of this study was to compare the predictive value of the valgus stress angle (SA), varus SA and varus-valgus SA difference (VVD) in predicting the degree of medial release in varus deformity during total knee arthroplasty (TKA).
Materials and Methods: One hundred eight TKAs (78 patients), which were performed in primary osteoarthritis with varus knee deformity, were retrospectively classified into three groups according to the degree of medial release (group A, mild release; group B, moderate release; and group C, severe release). Medical charts were reviewed, and long weight bearing standing anteroposterior radiographs and varus-valgus stress radiographs were evaluated.
Results: The valgus SA was significantly different between group A and B and between group A and C. However, it was not significantly different between group B and C. The varus SA was significantly different between group B and C and between group A and C. However, it was not significantly different between group A and B. The VVD was significantly different in all intergroup comparisons.
Conclusions: Evaluation of the VVD is more valuable in predicting the degree of medial release in TKA performed in varus knee deformity than evaluation of the simple valgus and varus SA.
Keywords: Knee, Arthroplasty, Varus, Varus-valgus stress angle difference, Medial release

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