A 38-year-old woman has lateral compartment knee osteoarthritis with 15 degrees of valgus and preserved medial cartilage. She is a manual labourer and wishes to avoid arthroplasty. The most appropriate realignment procedure is:

• A Lateral closing wedge high tibial osteotomy
• B Medial opening wedge high tibial osteotomy
• C Distal femoral varus osteotomy ✓
• D Proximal tibial derotation osteotomy

Explanation

In valgus knees with lateral compartment arthritis, the deformity apex lies in the distal femur, so correction is performed at the site of deformity through a distal femoral varus osteotomy, typically a medial closing wedge. High tibial osteotomy corrects varus deformities and would worsen valgus alignment. Derotation osteotomy addresses torsion, not coronal plane malalignment. Correcting at the true site of deformity preserves joint orientation and restores a neutral mechanical axis.

Reference: Rockwood and Green's Fractures in Adults, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.