3D Surgical Planning and Patient-Specific Instrumentation to Treat Chronic Knee Instability: A Case Report

Area of Science:

• Orthopedic surgery
• Trauma reconstruction
• Knee biomechanics

Background:

• Chronic knee instability and contracture can result from complex trauma, such as Gustilo type IIIA open fractures.
• Previous treatments may fail to fully restore stability and function, necessitating advanced reconstructive techniques.

Purpose of the Study:

• To describe a staged treatment protocol for a patient with chronic posttraumatic knee instability and anterolateral tibial plateau deficiency.
• To evaluate the efficacy of hexapod external fixation combined with patient-specific 3D-guided osteotomy in joint preservation.

Main Methods:

• A staged approach was employed, beginning with gradual correction of knee deformity using a hexapod external fixator.
• This was followed by a patient-specific, 3D-guided intra-articular osteotomy and posterolateral corner reconstruction.

Main Results:

• The treatment successfully addressed anterolateral tibial plateau deficiency and external rotatory subluxation.
• The patient regained knee stability and achieved full functional recovery, returning to all activities.

Conclusions:

• Hexapod-assisted external fixation provides effective gradual correction for complex knee deformities.
• Patient-specific 3D-guided osteotomy and reconstruction enable successful joint preservation in chronic posttraumatic knee instability.