Correcting varus deformity.

We report our technique and the results of treating severe intra- and extra-articular varus deformity using posterior stabilized fixed-bearing implants. We used a technique of selective posteromedial release and reduction osteotomy of posteromedial tibial flare in 173 knees in 117 patients. Proximal tibial osteotomy was used to correct severe extra-articular deformity. Mean tibiofemoral varus of 22 degrees preoperatively was corrected to 5.3 degrees valgus postoperatively. A total of 86% knees were in 4 degrees to 10 degrees valgus postoperatively. Mean Knee Society score improved from 22.8 to 91.1, and function score from 22.8 to 72.1 at 2 to 9 years. Of 30 bone grafts for tibial defects, 28 were successfully incorporated. No patient reported significant instability. Three knees showed tibial component loosening. Our technique restored alignment and stability without the need for constrained implants.