Our study is a retrospective review of 216 pre-operative arthritic knees, which investigated the lower limb axial alignment using digitally-stitched films. Patients excluded from the study are those with history of previous tibial or femoral osteotomy, secondary gonarthrosis, rheumatoid arthritis, previous femoral or tibial fracture, patients for bilateral TKR, or history of hip surgery.
The mean age was 68-years old (range 39–86 years). The mean VCA was 7° (4.7–9.3) for men and 6.6° (4.9–9) for women. However, 71 patients (33%) had more than 7° VCA. Subsequently, 46 patients (21%) had tibial bowing producing an angle >1.5° between its mechanical and anatomic axis.
The 6° standard when used as a guide may result in suboptimal prosthesis positioning during conventional TKR surgery. Therefore our findings suggest that the femoral valgus correction angle has a broad range, and using standard femoral intramedullary guides should not be overlooked.