Dr. Marx recently participated on an expert panel on “Combined Multi-ligament, meniscus, and cartilage injuries of the knee” at the annual American Academy of Orthopaedic Surgeons Meeting. The symposium was moderated by Dr. Bruce Levy and Dr. Gregory Fanelli.
Multiligament knee injuries are commonly the result of knee dislocations and are complex surgical cases. In the symposium, each surgeon presented on a different aspect of multiligament knee injuries. Dr. Marx presented on Osteotomies (HTO/DFO) in the multiple-ligament injured knee. An osteotomy is a surgical operation where the bone is cut to change the leg’s alignment. It is often used to correct legs that are valgus (angled outward) or varus (angled inward). It can also be used to help relieve pain caused by osteoarthritis. More information on the procedure can be found at Dr. Marx’s previous blog post here.
Performing an osteotomy while reconstructing multiple knee ligaments is very uncommon and rarely indicated. However, if a patient’s leg is bowed in or out, the excess force on the ligaments may increase the risk of graft rupture, which would result in the need for revision surgery. As a result, it could benefit these patients to undergo an osteotomy.
The osteotomy procedure can be performed on the same day as the reconstruction, or the patient may elect to have the osteotomy procedure first followed by the reconstruction. Patients undergoing both procedures stay at the hospital overnight following the procedure. For some patients, the osteotomy is sufficient and ligament reconstruction is not necessary.