A 34-year-old man has lateral compartment knee osteoarthritis following a lateral meniscectomy, with 15 degrees of valgus alignment and pain limiting daily activity. Radiographs show the deformity arises from the distal femur. The most appropriate realignment procedure is:
- A Medial closing wedge distal femoral osteotomy ✓
- B Lateral closing wedge high tibial osteotomy
- C Total knee arthroplasty
- D Arthroscopic debridement
Correct answer: A. Medial closing wedge distal femoral osteotomy
Explanation
When the valgus deformity originates in the distal femur, shown by an abnormal lateral distal femoral angle, correction must be performed at the distal femur through a medial closing wedge distal femoral osteotomy. Correcting a femoral-based deformity at the tibia produces an oblique joint line, shear across the knee and poor outcomes. Arthroplasty is avoided in this young active patient, and debridement does not address the malalignment driving cartilage wear.
Reference: Campbell's Operative Orthopaedics, 14th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.