Bent but not Broken: Managing Severe Deformity in Total Knee Arthroplasty

Total knee arthroplasty (TKA) is a successful procedure for alleviating pain from advanced degenerative disease. Standard techniques of bone resection and soft tissue balancing are applicable in most cases. In cases of severe intraarticular or extraarticular deformity, specialized methods of soft tissue balancing, corrective osteotomy, and the use of constrained prosthetic components may be necessary to ensure a well-balanced and anatomically aligned TKA. Bone defects are commonly found in cases of severe deformity and require management with either prosthetic augmentation or bone grafting. The goal of this article is to describe preoperative planning and strategies for management of severe deformity in TKA.