Skip to main content

Is There an Indication for Correcting a Valgus Knee?

  • Chapter
  • First Online:
Patellofemoral Pain, Instability, and Arthritis
  • 1562 Accesses

Abstract

While most procedures in the treatment of patellofemoral instability address the static or dynamic stabilizers of the patella, there are still other factors that need to be considered during the process of preoperative decision-making. Limb malalignment and its resultant force vectors are one such important factor for normal biomechanical function of the lower extremity. Frontal plane valgus deformity is particularly important, as it may lead to chronic patellofemoral instability and lateral dislocation [1]. Consequently, soft tissue procedures performed with a background of such preexisting deformity show a higher rate of failure [2].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. McWalter EJ, Cibere J, MacIntyre NJ, et al. Relationship between varus-valgus alignment and patellar kinematics in individuals with knee osteoarthritis. J Bone Joint Surg Am. 2007;89:2723–31. https://doi.org/10.2106/JBJS.F.01016.

    Article  PubMed  Google Scholar 

  2. Bruce WD, Stevens PM. Surgical correction of miserable malalignment syndrome. J Pediatr Orthop. 2004;24:392–6.

    Article  PubMed  Google Scholar 

  3. Boden B, Pearsall A, Garrett W, Feagin J. Patellofemoral instability: evaluation and management. J Am Acad Orthop Surg. 1997;5:47–57.

    Article  PubMed  Google Scholar 

  4. Hermans K, Claes S, Bellemans J. Valgus instability as a cause for recurrent lateral patellar dislocation: a new mechanism for patellofemoral instability? Acta Orthop Belg. 2013;79:495–501.

    PubMed  Google Scholar 

  5. Eilert RE. Congenital dislocation of the patella. Clin Orthop Relat Res. 2001;389:22–9.

    Article  Google Scholar 

  6. Dejour D, Le Coultre B. Osteotomies in patello-femoral instabilities. Sports Med Arthrosc. 2018;26:8–15. https://doi.org/10.1097/JSA.0000000000000183.

    Article  PubMed  Google Scholar 

  7. Frosch KH, Schmeling A. A new classification system of patellar instability and patellar maltracking. Arch Orthop Trauma Surg. 2016;136:485–97. https://doi.org/10.1007/s00402-015-2381-9.

    Article  PubMed  Google Scholar 

  8. Puddu G, Cipolla M, Cerullo G, et al. Which osteotomy for a valgus knee? Int Orthop. 2010;34:239–47. https://doi.org/10.1007/s00264-009-0820-3.

    Article  PubMed  Google Scholar 

  9. Phisitkul P, Wolf BR, Amendola A. Role of high tibial and distal femoral osteotomies in the treatment of lateral-posterolateral and medial instabilities of the knee. Sports Med Arthrosc. 2006;14:96–104. https://doi.org/10.1097/01.jsa.0000212306.47323.83.

    Article  PubMed  Google Scholar 

  10. Grelsamer RP, Klein JR. The biomechanics of the patellofemoral joint. J Orthop Sports Phys Ther. 1998;28:286–98. https://doi.org/10.2519/jospt.1998.28.5.286.

    Article  PubMed  Google Scholar 

  11. Rosso F, Margheritini F. Distal femoral osteotomy. Curr Rev Musculoskelet Med. 2014;7:302–11. https://doi.org/10.1007/s12178-014-9233-z.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Imhoff FB, Beitzel K, Zakko P, et al. Derotational osteotomy of the distal femur for the treatment of patellofemoral instability simultaneously leads to the correction of frontal alignment: a laboratory cadaveric study. Orthop J Sports Med. 2018;6:2325967118775664. https://doi.org/10.1177/2325967118775664.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Collins B, Getgood AM, Alomar AZ, et al. A case series of lateral opening wedge high tibial osteotomy for valgus malalignment. Knee Surg Sports Traumatol Arthrosc. 2013;21:152–60. https://doi.org/10.1007/s00167-012-2070-y.

    Article  PubMed  Google Scholar 

  14. Ranawat AS, Nwachukwu BU, Pearle AD, et al. Comparison of lateral closing-wedge versus medial opening-wedge high Tibial osteotomy on knee joint alignment and kinematics in the ACL-deficient knee. Am J Sports Med. 2016;44:3103–10. https://doi.org/10.1177/0363546516657824.

    Article  PubMed  Google Scholar 

  15. Cole BJ, Sekiya JK. Surgical techniques of the shoulder, elbow and knee in sports medicine E-Book. Philadelphia, PA: Elsevier Health Sciences; 2013.

    Google Scholar 

  16. Woodacre T, Ricketts M, Evans JT, et al. Complications associated with opening wedge high tibial osteotomy—a review of the literature and of 15 years of experience. Knee. 2016;23:276–82. https://doi.org/10.1016/j.knee.2015.09.018.

    Article  PubMed  Google Scholar 

  17. Uhl JF, Gillot C. Anatomy of the Hunter's canal and its role in the venous outlet syndrome of the lower limb. Phlebology. 2015;30:604–11. https://doi.org/10.1177/0268355514551086.

    Article  PubMed  Google Scholar 

  18. Pagenstert G, Wolf N, Bachmann M, et al. Open lateral patellar retinacular lengthening versus open retinacular release in lateral patellar hypercompression syndrome: a prospective double-blinded comparative study on complications and outcome. Arthroscopy. 2012;28:788–97. https://doi.org/10.1016/j.arthro.2011.11.004.

    Article  PubMed  Google Scholar 

  19. Sabbag OD, Woodmass JM, Wu IT, et al. Medial closing-wedge distal femoral osteotomy with medial patellofemoral ligament imbrication for genu valgum with lateral patellar instability. Arthrosc Tech. 2017;6:e2085–91. https://doi.org/10.1016/j.eats.2017.08.012.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Saithna A, Kundra R, Modi CS, et al. Distal femoral varus osteotomy for lateral compartment osteoarthritis in the valgus knee. A systematic review of the literature. Open Orthop J. 2012;6:313–9. https://doi.org/10.2174/1874325001206010313.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Purushothaman B, Agarwal A, Dawson M. Posttraumatic chronic patellar dislocation treated by distal femoral osteotomy and medial patellofemoral ligament reconstruction. Orthopedics. 2012;35:e1668–72. https://doi.org/10.3928/01477447-20121023-30.

    Article  PubMed  Google Scholar 

  22. Kwon JH, Kim JI, Seo D-H, et al. Patellar dislocation with genu valgum treated by DFO. Orthopedics. 2013;36:840–3. https://doi.org/10.3928/01477447-20130523-35.

    Article  PubMed  Google Scholar 

  23. Swarup I, Elattar O, Rozbruch SR. Patellar instability treated with distal femoral osteotomy. Knee. 2017;24:608–14. https://doi.org/10.1016/j.knee.2017.02.004.

    Article  PubMed  Google Scholar 

  24. Wilson PL, Black SR, Ellis HB, Podeszwa DA. Distal femoral valgus and recurrent traumatic patellar instability: is an isolated varus producing distal femoral osteotomy a treatment option? J Pediatr Orthop. 2018;38:e162–7. https://doi.org/10.1097/BPO.0000000000001128.

    Article  PubMed  Google Scholar 

  25. Nha K-W, Ha Y, Oh S, et al. Surgical treatment with closing-wedge distal femoral osteotomy for recurrent patellar dislocation with genu Valgum. Am J Sports Med. 2018;46:1632–40. https://doi.org/10.1177/0363546518765479.

    Article  PubMed  Google Scholar 

  26. Frings J, Krause M, Akoto R, et al. Combined distal femoral osteotomy (DFO) in genu valgum leads to reliable patellar stabilization and an improvement in knee function. Knee Surg Sports Traumatol Arthrosc. 2018;39:1756. https://doi.org/10.1007/s00167-018-5000-9.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alan Getgood .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 ESSKA

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Roessler, P.P., Getgood, A. (2020). Is There an Indication for Correcting a Valgus Knee?. In: Dejour, D., Zaffagnini, S., Arendt, E., Sillanpää, P., Dirisamer, F. (eds) Patellofemoral Pain, Instability, and Arthritis. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-61097-8_37

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-61097-8_37

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-61096-1

  • Online ISBN: 978-3-662-61097-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics