A 52-year-old woman has lateral compartment knee osteoarthritis with 18 degrees of valgus alignment and a visible lateral thrust on walking. Conservative measures have failed. Which realignment procedure is most appropriate?
- A Medial closing wedge distal femoral osteotomy ✓
- B Medial opening wedge high tibial osteotomy
- C Arthroscopic lateral compartment debridement
- D Lateral closing wedge high tibial osteotomy
Correct answer: A. Medial closing wedge distal femoral osteotomy
Explanation
Valgus deformity above roughly 12 to 15 degrees, or with a lateral thrust, lies mainly in the distal femur, so correction belongs at the distal femur. D distal femoral varus osteotomy corrects at the true apex and keeps the joint line horizontal. Performing a high tibial osteotomy for this degree of valgus produces an unacceptable oblique joint line and shear forces across the knee.
Reference: Insall & Scott Surgery of the Knee, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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