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Clinical Orthopaedics and Related Research®

Published in:

01-04-2012 | Symposium: Arthroscopy

Can Wedge Osteotomy Correct Depression of the Lateral Tibial Plateau Mimicking Posterolateral Rotatory Knee Instability?

Authors: Miguel A. Ayerza, MD, Federico Suarez, MD, Matias Costa-Paz, MD, D. Luis Muscolo, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 4/2012

Abstract

Background

The literature suggests rotatory knee instability (pseudolaxity) can be associated with depressions of the lateral tibial plateau in patients despite an intact arcuate ligament complex. Correcting this bone deformity by an open-wedge osteotomy of the lateral tibia plateau, elevating the depressed bone may restore knee stability.

Questions/purposes

We therefore asked whether: (1) knee stability is restored after this procedure; (2) Lysholm functional scores improve after this treatment; and (3) the limb alignment changes.

Patients and Methods

We retrospectively evaluated 12 patients who underwent a subchondral open-wedge osteotomy of the lateral tibial plateau combined with a knee arthroscopic procedure for the treatment of a knee rotational instability secondary to a lateral compartment bone deficit between 2000 and 2007. Eleven patients with a mean age of 35 years were available for followup at a minimum of 2 years (average, 5.4 years; range, 2–9 years). Preoperatively and at last followup, patients were clinically and radiographically evaluated by the Lysholm score and with comparative knee radiographs. Complications were recorded.

Results

At last followup all patients rated their knees as stable. All osteotomies healed uneventfully. The Lysholm score improved from 62 to 87. Followup radiographs showed no changes in the femorotibial axis as result of the osteotomy.

Conclusions

Patients with chronic depression of the posterolateral tibial plateau may exhibit symptoms of posterolateral knee instability, a sort of pseudolaxity. In these patients, an open-wedge osteotomy of the lateral tibia plateau, elevating the depressed bone, and tensioning posterolateral structures improves this secondary posterolateral knee instability.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Title: Can Wedge Osteotomy Correct Depression of the Lateral Tibial Plateau Mimicking Posterolateral Rotatory Knee Instability?
Authors: Miguel A. Ayerza, MD
Federico Suarez, MD
Matias Costa-Paz, MD
D. Luis Muscolo, MD
Publication date: 01-04-2012
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 4/2012
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-011-1855-5

At a glance: The STEP trials

Springer Medicine

Can Wedge Osteotomy Correct Depression of the Lateral Tibial Plateau Mimicking Posterolateral Rotatory Knee Instability?

Abstract

Background

Questions/purposes

Patients and Methods

Results

Conclusions

Level of Evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Questions/purposes

Patients and Methods

Results

Conclusions

Level of Evidence

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