Table 2.

Simplified flowchart for managing complex knee deformities with total knee arthroplasty.

Surgical plan	Indications
Primary TKA- Standard TKA with conventional, symmetric bone resection cuts with navigation	•Deformity further away from Knee joint with minimal MAD •Deformity close to knee with minimal MAD
Primary TKA - Standard navigated TKA with asymmetric bone resection	•Femoral extra-articular deformity with MAD angle <10 degrees, collateral ligaments are not compromised •Tibia extra-articular deformity with MAD angle <15 degrees, collateral ligaments are not compromised •Angular deformity in isolation is of little help and therefore, deformity should be considered with its overall effect on mechanical axis. •Uniapical simple deformities •Elderly patient with limited function ? rotating hinge
Single-stage procedure: Simultaneous corrective osteotomy and TKA	•Simple uniapical deformity, which cannot be corrected by intra-articular resection •Patient (usually elderly) with simple or complex deformity, where 2-stage procedure is not preferable– Standard TKA or rotating hinge
2-stage procedure: Corrective osteotomy followed by delayed TKA	•Young patient <55 years •Patients between 55 and 65 –Physiologically fit and young. •Complex deformity •Multiplanar deformity •Large extra-articular deformity unable to correct with intra-articular resection •Large deformity where intra-articular correction will compromise collateral ligaments •Leg length discrepancy