Re-revision surgery for re-recurrent valgus deformity after revision total knee arthroplasty in a patient with a severe valgus deformity: A case report

Figure 1 The radiographs of left knee at 6 months after primary total knee arthroplasty showed the signs of femoral component loosening and recurrent valgus deformity. A: Anteroposterior radiograph; B: Lateral radiograph.

Figure 2 The radiographs after revision total knee arthroplasty showed residual valgus deformity. A: Anteroposterior radiograph; B: Lateral radiograph; C: The standing hip-to-ankle anteroposterior radiograph.

Figure 3 The radiographs at 6 years after revision total knee arthroplasty showed signs of the loosening of femoral components and recurrent valgus deformity, and the femoral cementless stem broke through the cortical bone of femur. A: Anteroposterior radiograph; B: Lateral radiograph; C: The standing hip-to-ankle anteroposterior radiograph.

Figure 4 Intraoperative images. A: Removal of femoral components from the previous revision and the cementless stem; B: Tremendous bone defects (type FB) in the lateral femoral condyle; C: The screws were used to reconstruct the defects of the lateral femoral condyle; D: A total condylar femoral component with a sleeve that was implanted with a hybrid fixation and the cement reinforced with screws was used to reconstruct the defects of the lateral femoral condyle.

Figure 5 The radiographs after re-revision total knee arthroplasty. The positions of the components were satisfactory based on the radiographs, and an appropriate neutral alignment of the lower limb was restored. A: Anteroposterior radiograph; B: Lateral radiograph; C: The standing hip-to-ankle anteroposterior radiograph.

Figure 6 The radiographs at 2. 5 years after re-revision total knee arthroplasty. The left knee arthroplasty was in the expected position with no radiographic signs of loosening. A: Anteroposterior radiograph; B: Lateral radiograph; C: The standing hip-to-ankle anteroposterior radiograph.