The inwardly pointing knee. An unrecognized problem of external rotational malalignment

Area of Science:

• Orthopedic surgery
• Biomechanical analysis
• Knee joint disorders

Background:

• Chronic knee pain and disability often stem from patellofemoral subluxation.
• Patients unresponsive to conservative treatments require alternative surgical interventions.
• Limb alignment deviations, particularly in the tibia, are implicated in knee pathologies.

Purpose of the Study:

• To investigate limb alignment differences in patients with chronic knee pain and inwardly pointing knees.
• To evaluate the efficacy of surgical correction for tibial deformities contributing to patellofemoral subluxation.

Main Methods:

• Radiographic analysis of limb alignment in twelve patients and forty-nine healthy controls.
• Surgical intervention using derotation valgus Maquet osteotomy of the tibia and lateral release realignment of the patellae in seven patients (nine knees).

Main Results:

• Significant differences in tibial alignment, including external tibial torsion and varus angulation, were observed in patients compared to controls.
• Surgical correction resulted in excellent outcomes after a three-year follow-up in five knees.
• Satisfactory early results were noted in the remaining cases.

Conclusions:

• Tibial deformities are a significant factor in chronic knee pain and disability suggestive of patellofemoral subluxation.
• Maquet osteotomy combined with lateral release is an effective surgical treatment for correcting these deformities.
• This surgical approach offers promising results for patients with complex knee alignment issues.