Single- and dual-component revisions have typically been used to correct coronal malalignment after total knee arthroplasty (TKA). However, realignment of well-fixed components can result in complications such as bone loss and the need for increasing constraint of implants. Exchange to a custom-made angled polyethylene insert, although primarily implemented in cases of osteolysis, has been described with low complication rates and minimal loss of motion. We describe a 74-year-old woman who underwent TKA in January 2006 and presented to our clinic in March 2013 with symptoms of pain and instability of the right knee. We performed a revision TKA using two polyethylene inserts and achieved stability in varus and valgus stress levels. Postoperatively, the patient was satisfied with her ambulation. The use of angled polyethylene inserts in revision TKA may be as effective in treatment of malalignment as osteolysis and may provide better clinical outcomes than component revisions.
Kuehn, Reilly J. and Ch Christopher R Hanosh. "Custom-made Angled Polyethylene Insert Exchange for Treatment of Valgus Malalignment in Revision Total Knee Arthroplasty: A Case Report." UNM Orthopaedic Research Journal 4, 1 (2015). https://digitalrepository.unm.edu/unm_jor/vol4/iss1/25