TKR Lateral PKR vs DFO in valgus knock-knee…


new member
May 6, 2022
United States United States
Hi all -

Trying to see if anyone has had any experience with anything related to my situation.

I’m 52 male, active, snowboarder (until recently), with lifelong mild knee issues in part due to being knock-kneed. In more technical terms I have a valgus deformity of about 8-10 degrees although that’s gotten a little worse now that the meniscus has worn away on that side.

I’ve now got some bone on bone situation in the lateral compartment of my right knee, which makes sense given the extra forces being knock kneed puts on the outer part of the knee. (For the record I also had an ACL reconstruction on that knee 20 years ago.). I can’t snowboard anymore, stopped running or anything like it a long time ago, and the range of activities I can’t do is increasing. Also it just hurts a bit pretty constantly; not terrible, but a bit.

I’ve been seeing doctors about what to do and have been offered two options.

1) a Distal Femoral Osteotomy or DFO to straighten the leg and correct valgus and thus take pressure off that lateral compartment, 2) a lateral unicompartmental knee arthoplasty or LUKA, aka a lateral partial knee replacement, Or 3), do nothing, give up being so active, and just deal with the worsening knee.

One expert doctor who specializes in DFOs says I should do a DFO; another expert doctor who does both DFOs and LUKAs suggests I do a LUKA, also known here as a lateral PKR, in part because where my cartilage has worn away to bone on bone is more to the rear of the knee and he thinks the DFO won’t help much.

I understand I’m done doing really high impact stuff like running, but the hope is to get the knee on a better path for the rest of my life, and not do some big surgery and end up the same or worse than where I started.

I have no way to determine which of these doctors is right, so I’m looking for any real world experience from people.

My understanding is that both these operations are fairly rare - most partial knee replacements are on the medial side, not the lateral side - and I’ve had a hard time finding information about outcomes for patients who have a valgus knock-knee deformity like mine. So I’m hoping to any other knock kneed people like myself who have done either of these surgeries, or anyone who’s had either a DFO or a lateral PKR, or anyone with anything to add in general.



Staff member since November 2017
BoneSmart Staff
Jun 26, 2017
United States United States
Hello and Welcome to BoneSmart. Thanks for joining us! While I don’t have any advice for you since I experienced hip replacement, rather than knee, I’m sure some members will come along with feedback. In the meantime, I’ll leave you some reading material with best wishes as you research and formulate a plan that will bring you relief.

Also, consider using the SEARCH at the top of the page to type in different topics you’re researching such as “valgus deformity” and the threads where it’s been mentioned will pop up.
Wishing you all the best! :)

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:
Score Chart: How bad is my arthritic knee?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:
Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?

Regardless of where you are in the process, the website and app My Knee Guide can help you stay organized and informed. The free service keeps all the information pertaining to your surgery and recovery in one place on your smartphone. It is intended to be a personal support tool for the entire process.

And if you want to picture what your life might be like with a replaced knee, take a look at the posts and threads from other BoneSmarties provided in this link:
Stories of amazing knee recoveries


Jan 14, 2022
United States United States
Hi @TeeGee , I had an LTKR 3 weeks ago - my left knee was "severely valgus" - the gap between the femur and tibia on the medial side was 11.10 mm (I think it was 13-14% knocked). My right knee (5 months ago) was "severely varus" (9.98 mm gap on the lateral side) ... also a TKR.

You can check out my posting for background in re how I ended up requiring TKRs ( ... it's a long rambling post. :)

I plan to return to a very active life once my left knee has been rehabbed ... hiking, "running", biking, basketball.

All the best!

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