Revision Surgery due to Patient Dissatisfaction with Remaining Valgus leg Alignment after Kinematically Aligned Total Knee Arthroplasty: A Case Report

BACKGROUND: The kinematic alignment (KA) technique aims to achieve true resurfacing of the knee joint and recreate prearthritic anatomy while preserving soft tissues. However, it remains uncertain whether all prearthritic anatomies are biomechanically equivalent and if KA is suitable for cases with extreme anatomical variations. CASE PRESENTATION: The case of a 75-year-old female patient with a moderate valgus deformity who underwent kinematically aligned total knee arthroplasty (TKA) was reported. The patient required early revision surgery due to persistent pain in the medial collateral ligament area and dissatisfaction with the postoperative leg alignment. CONCLUSION: There is a paucity of studies addressing the outcomes of kinematically aligned TKA in patients with valgus knees. Concerns persist regarding the suitability of unrestricted KA for all anatomical variations, particularly extreme ones. This case underscores the importance of considering restricted KA as a potentially safer alternative. In addition, patient perception of limb alignment and appearance significantly impacts the success of total knee arthroplasty, particularly in cases with valgus deformities.