The correction of severe varus deformity in total knee arthroplasty by tibial component downsizing and resection of uncapped proximal medial bone.

The clinical and radiologic outcome of 10 patients (12 knees) with a mean varus deformity of 24 degrees (range, 20 degrees to 40 degrees ) treated with total knee arthroplasty (TKA) is presented. We describe a technique of downsizing and lateralizing the tibial component with subsequent removal of the proximal medial tibia flush with the downsized component. At a mean follow-up of 42 months (range, 12 to 64 months), the mean preoperative Knee Society and function scores had improved from 24 and 34 to 94 and 85, respectively, at follow-up. No implant has been revised. At follow-up evaluation, no evidence of osteolysis or radiographic loosening was seen and the mean tibiofemoral angle was 4 degrees of valgus. This technique provides mid-term stable correction and excellent clinical and radiographic results in patients with severe varus deformity.