is it safe to use a six-degree distal femoral valgus cut in all genu varus patients with total knee arthroplasty?

Background: during a total knee arthroplasty, it is common to make a distal femoral cut based on the femoral mechanical-anatomical angle (fma), which in most patients is six degrees. however, in patients with a higher fma, there is not yet a consensus between surgeons regarding the degree of the cutting angle. objectives: the aim of this study is to assess the treatment outcomes of patients with a fma of more than seven degrees who were treated by distal femoral cuts of six degrees during a total knee arthroplasty. methods: we retrospectively reviewed the clinical and radiological results of patients who were treated at our center by a conventional valgus cut of six degrees during a total knee arthroplasty and had a fma of more than seven degrees. a knee society score (kss) was completed for all patients during follow-up visits. results: a total of 31 cases with knee osteoarthritis and a fma of more than seven degrees were enrolled in this study. the cases consisted of 8 men and 23 women with an average age of 65.41 (range 46 - 77 years) (sd ± 7.61) years and a mean follow-up time of 11.51 months (range 3 - 24 months) (sd ± 6.08). the mean kss was 148.51 (sd ± 7.43), (range 132 to 167), which is considered good. there was a statistically significant relationship between the lateral distal femoral angle (ldfa) and fma. however, there was not a statistically significant correlation between ldfa and kss. conclusions: although the overall alignment of the lower extremity in our patients was in varus, this amount of varus does not prove to have an effect on the outcome.