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Anterior Knee Pain and Excessive External Tibial Torsion in Female Patients: Rationale and Outcomes of Rotational
Vicente Sanchis-Alfonso1, Jesus Castellano-Curado2, Erik Montesinos-Berry3
1Department of Orthopaedic Surgery, Hospital Arnau de Vilanova, 46015 Valencia, Spain.
Abstract:
Excessive external tibial torsion (ETT) is a recognized cause of anterior knee pain (AKP). In patients with excessive ETT, placing the foot forward during gait causes the knee joint to point inward, increasing the Q-angle and the lateral quadriceps vector. In appropriately selected cases, internal rotational tibial osteotomy is a reliable treatment option for symptomatic excessive ETT, yielding favorable outcomes with minimal complications. Nevertheless, no universally accepted torsion threshold exists to guide surgical decision-making, and evidence remains limited regarding the optimal anatomic level for performing the osteotomy.
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