Postoperative Coronal Alignment After Total Knee Arthroplasty: Does Tailoring the Femoral Valgus Cut Angle Really Matter?

Postoperative alignment was measured in 80 TKA divided into 2 groups. Knees in the tailored group (n = 40) were performed with a personalized valgus cut angle (VCA) based on preoperative hip-to-ankle (HTA) radiographs. The fixed group knees (n = 40) were performed utilizing a 4° VCA in valgus knees and obese patients, and 5° in neutral and varus knees. There was no significant difference between groups in average preoperative mechanical alignment or average severity of preoperative deformity. There was no statistically significant difference between groups in postoperative mechanical alignment (tailored: 2.6°; fixed: 1.3°; P = 0.08) or severity of residual deformity (tailored: 3.5°; fixed: 2.6°; P = 0.10). Accuracy of the tibial cut angle (TCA) and severity of the preoperative deformity were strong independent predictors of postoperative alignment (R² = 58% and R² = 33%, respectively).