| A 48-year-old female patient with lateral left knee pain and valgus malalignment has standing hip-knee-ankle radiographs that reveal an anatomic tibiofemoral angle of 9° of valgus. The deformity is correctable, and the patient has not undergone any prior surgical procedures. This patient may benefit from which of the following interventions? |
- Opening proximal medial tibial osteotomy Performing a medial opening osteotomy in the proximal aspect of the tibia will push the joint into further valgus, causing increasing load in the lateral compartment.
- Medial unicompartmental knee arthroplasty A medial unicompartmental replacement would not address this patient’s issue. She has overall valgus alignment; therefore, the advanced wear in the joint would be to the lateral compartment. The patient is young and has not failed nonoperative measures; therefore, an operation would not be the first option.
- Lateral femoral condyle osteochondral autograft transfer The question does not describe an articular cartilage defect in the lateral compartment and, therefore, an osteochondral transfer is not appropriate.
- Medial wedge insole The medial heel wedge would unload the lateral compartment and would be a reasonable initial nonoperative intervention in this case.