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CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2022; 63(02): e108-e122
DOI: 10.1055/s-0042-1755535
Artículo de Revisión | Review Article

Current Concepts in Double-Level Osteotomies around the Knee

Article in several languages: español | English
Pedro Díaz-Allende 
1   Grupo de Estudio Rodilla, Artroscopía y Reconstrucción, Chile
2   Hospital Ricardo Valenzuela Sáez, Rengo, Chile
,
Robert Partarrieu-Stegmeier 
2   Hospital Ricardo Valenzuela Sáez, Rengo, Chile
,
Oscar Colmenares-Sandoval 
1   Grupo de Estudio Rodilla, Artroscopía y Reconstrucción, Chile
3   Hospital Sótero del Río, Santiago, Chile
,
David Figueroa-Poblete
4   Clínica Alemana, Departamento de Cirugía Ortopédica, Santiago, Chile
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Abstract

With single-level osteotomy, correction of the limb axis in patients with combined femoral and tibial deformities can be achieved. This correction, however, will generate a pathological alteration in the joint line oblicuity, leading to ligament elongation, instability, joint degeneration and, ultimately, it will compromise the longevity and functional results of the correction. By analyzing the most recent literature, we can conclude that there is a significant number of patients who require a combined procedure to achieve an optimal biomechanical goal. The purpose of a double-level osteotomy around the knee is to restore normal anatomy, unload the affected compartment, normalize the mechanical angles and the orientation of the joint line. Physiological axes can be reestablished by means of a thorough preoperative analysis, observing the biomechanical principles and stable fixation with locked plates. It is a demanding procedure with increasing indications, which has progressively been established in clinical and biomechanical studies as a justified treatment alternative for the management of severe deformities around the knee.

Keywords

Mikulicz line - joint line obliquity - double-level osteotomy - distal femoral osteotomy - high tibial osteotomy - osteotomy around the knee


Publication History

Received: 20 August 2021

Accepted: 20 June 2022

Article published online:
03 October 2022

© 2022. Sociedad Chilena de Ortopedia y Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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