PURPOSE To describe a surgical technique in correcting valgus deformity during total knee replacement and evaluate medium-term clinical outcomes. METHODS This was a retrospective consecutive series of total knee replacement for severe valgus deformity of patients who underwent a lateral ligament complex release with a sliver osteotomy of the lateral femoral condyle with a minimum 1-year follow-up and recording objective and patient-reported outcome measures. RESULTS Twenty-three patients (25 knees) were included with median follow-up of 5 years (range 1-15 years) and average age 67.7 years (range 43-87). The primary diagnosis was osteoarthritis in 14 patients (61%) and inflammatory arthritis in 9 patients (39%). At final follow-up, the median mechanical tibiofemoral angle was restored to 4° (range 2-7) compared with a median valgus of 20° (range 13-30) preoperatively. This was statistically significant (P < 0.00001). Median Oxford Knee Score at final follow-up was 43 (range 36-48) indicating satisfactory outcomes. There were no revisions for any cause with a mean arc range of movement 110° (range 85-120). CONCLUSION This study shows that a technique utilising the familiar medial parapatellar approach, staged soft tissue releases, and a novel sliver lateral femoral condylar osteotomy with intact periosteum to release the lateral ligament complex leads to satisfactory medium-term outcomes, improved range of movement and patients' reported outcome measures. Sliver osteotomy is a useful technique in correcting valgus deformity in total knee replacements at medium-term follow-up. LEVEL OF EVIDENCE IV.

中文翻译：

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中期con骨外侧截骨术可令人满意的中期结局，以纠正全膝关节置换术中的外翻畸形。

目的描述在全膝关节置换术中纠正外翻畸形的外科手术技术，并评估中期临床效果。方法这是一项回顾性连续系列全膝关节置换术，用于治疗严重的外翻畸形的患者，这些患者接受了外侧韧带复合体松解术并进行了股骨lateral外侧tom骨截骨术，并进行了至少一年的随访，并记录了客观和患者报告的结局措施。结果纳入23例患者（25膝）​​，中位随访5年（范围1-15岁），平均年龄67.7岁（范围43-87岁）。初步诊断为骨关节炎14例（61％）和炎性关节炎9例（39％）。在最后的随访中，术前胫骨股骨中位机械角恢复至4°（范围2-7），而外翻中位值为20°（范围13-30）。这具有统计学意义（P <0.00001）。最后一次随访的牛津膝关节评分中位数为43（范围36-48），表明结果令人满意。对于任何原因，均没有修订，其平均弧度移动范围为110°（范围为85-120）。结论这项研究表明，利用熟悉的内侧para骨旁入路，分阶段软组织释放，以及具有完整的骨膜的新型股骨外侧con骨截骨术来释放外侧韧带复合体的技术可带来令人满意的中期结果，改善的活动范围和患者报告了结果指标。在中期随访中，银截骨术是纠正全膝关节置换中外翻畸形的有用技术。证据级别IV。