Total Knee Arthroplasty for Severe Valgus Knee Deformity with a Thin Bowl Shaped Patella

Valgus knee is associated with exaggerated dysfunction of the patello-femoral joint and the lateral compartment of the femorotibial joint, and may be associated with contracture of the lateral soft tissues and laxity of the medial soft tissues. The authors encountered a case of severe valgus knee deformity with a thin bowl-shaped patella. The case was treated with total knee arthroplasty (TKA), using a lateral approach. It was not possible to resurface the patella. Osteotomy of the patella was performed to enhance patellar tracking. After surgery, the complication of postoperative skin necrosis developed. A pedicled muscle flap from the lateral head of the gastrocnemius muscle and all layers of the skin were grafted. The patient has been symptom-free for following surgery.