65 yrs old lady came to us with pain and severely deformed valgus knee joints. She was having difficulty in walking and sitting for the past 9 months. Her xrays and clinical examination showed fixed valgus osteoarthritic knee joints. Thus she planned for knee replacement surgery. These complex valgus knee replacement surgery requires meticulous surgical planning in terms of soft tissue balancing and sometimes need constrained knee prosthesis. Postoperative xrays showed well balanced and straight knees. Now She is walking comfortably with straight legs. We routinely performed such complex surgeries at Sant Parmanand Hospital.