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Alignment Correction Procedures for the Knee: When, Where, and How to Perform

March 01, 2017

Contributors: Jack Anavian, MD; Jonathan Mordechai Frank, MD; Robert F LaPrade, MD, PhD; Justin J Mitchell, MD; BURU GILBERT MOATSHE; George Sanchez, BS; Jorge Chahla Jr, MD; Jorge Chahla Jr, MD

Recently, knee malalignment has gained increased attention because of the desire for joint preservation in young and active patients. Previously, varus and valgus malalignment were believed to increase the risk for medial and lateral knee compartment osteoarthritis. In addition, variations in anatomic knee positioning were believed to increase the risk of central and collateral ligament repair or reconstruction failure. Recently, tibial slope has been found to play a crucial role in ligamentous knee injuries. Given recent advancements, surgeons must be comfortable with surgical approaches and treatment options for patients with these anatomic knee variations.  This video presents three common approaches to manage knee malalignment: medial opening wedge proximal tibial osteotomy to manage varus deformity, lateral distal femoral opening wedge osteotomy to manage valgus deformity, and anterolateral opening wedge proximal tibial osteotomy for biplanar correction in a patient with valgus deformity and a decreased tibial slope.

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