Abstract
With single-level osteotomy, correction of the limb axis in patients with combined
femoral and tibial deformities can be achieved. This correction, however, will generate
a pathological alteration in the joint line oblicuity, leading to ligament elongation,
instability, joint degeneration and, ultimately, it will compromise the longevity
and functional results of the correction. By analyzing the most recent literature,
we can conclude that there is a significant number of patients who require a combined
procedure to achieve an optimal biomechanical goal. The purpose of a double-level
osteotomy around the knee is to restore normal anatomy, unload the affected compartment,
normalize the mechanical angles and the orientation of the joint line. Physiological
axes can be reestablished by means of a thorough preoperative analysis, observing
the biomechanical principles and stable fixation with locked plates. It is a demanding
procedure with increasing indications, which has progressively been established in
clinical and biomechanical studies as a justified treatment alternative for the management
of severe deformities around the knee.
Keywords
Mikulicz line - joint line obliquity - double-level osteotomy - distal femoral osteotomy
- high tibial osteotomy - osteotomy around the knee
