Role of osteotomy in multiligament knee instability

Anshu Shekhar, Anoop Pilar, Sachin Tapasvi

Volume 5 | Issue 1 | Jan – April 2020 | Page 43-52

Author: Anshu Shekhar [1], Anoop Pilar [1], Sachin Tapasvi [1]

[1] The Orthopaedic Speciality Clinic, Pune

Address of Correspondence
Dr. Anshu Shekhar,
The Orthopaedic Speciality Clinic, Pune
E-mail: dr.anshushekhar@gmail.com

Abstract

Alignment of the lower limb (coronal, sagittal and axial) has a significant effect on knee stability in a multiligament injured knee. This malalignment can be due to a pre-existing condition like tibia vara, an abnormal tibial slope, a malunited intra articular fracture with ligament injury, or can develop later in a neglected case of instability. Restoration of limb alignment is one of important factors to restore the stability in these patients. The importance of performing an osteotomy in a ligament-deficient knee is to further prevent the articular cartilage wear, to protect the graft(s) from abnormally high stress, to restore stability and to restore geometry. Thus, an osteotomy has a more profound bearing in restoring knee laxity and reducing graft stress after any soft tissue reconstruction. An osteotomy can be performed either alone or with simultaneous ligament reconstruction, or as a staged procedure. This review analyses the importance of lower limb alignment, its impact on knee ligamentous stability, decision making and planning for an osteotomy and briefly discuss technical aspects of performing an osteotomy.
Keywords: Knee dislocation, Ligament injury, Osteotomy, Instability, Malalignment.

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