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Background: Severe valgus knee deformity is a challenge in total knee arthroplasty. Questions/purposes: We conducted selective release of tight lateral structures, and the lateral retinaculum in cases with patellar maltracking. We asked whether this selective release method: (1) obtained and maintained correction of the frontal plane deformity; (2) restored patellar tracking and function; and (3) avoided complications associated with extensive releases (including lateral condyle avascularity and residual lateral instability) and the need for a constrained implant.