knee Injuries. young sport man with strong athletic legs holding knee with his hands in pain after suffering muscle injury during a running workout training on Running Track. Healthcare and sport concept.
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.
