This case illustrates an approach to a young patient with a large varus deformity and LCL laxity. After analyzing the deformity, it became clear that the varus was coming from distal femur, proximal tibia, and joint line obliquity. Also present was a procurvatum deformity of the proximal tibia. We performed an acute deformity correction of the femur with a plate and a gradual correction of the tibia varus and procurvatum with a TSF. With correction of deformity, the LCL laxity improved dramatically.
32 year old male who complains of bilateral knee pain, left is worse than right and is unstable. Two years earlier, he underwent a high tibial osteotomy and MCL and PCL reconstructions. He feels persistent pain and instability.
Ashfaq K, Fragomen AT, Nguyen JT, Rozbruch SR: Correction of proximal Tibia Varus with External Fixation. J Knee Surgery 2012, 25(5):375-384.
Rozbruch SR, Segal K, Ilizarov S, Fragomen AT, Ilizarov G: Does the Taylor Spatial Frame Accurately Correct Tibial Deformities? Clin Orthop Rel Res 2010 May :468(5): 1352-61
Seah KT, Shafi R, Fragomen AT, Rozbruch SR: Distal Femoral Osteotomy: Is Internal Fixation Better than External? Clin Orthop Rel Res. 2011, 469: 2003-2011