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CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2022; 63(02): e108-e122
DOI: 10.1055/s-0042-1755535
DOI: 10.1055/s-0042-1755535
Artículo de Revisión | Review Article
Conceptos actuales en osteotomías en doble nivel alrededor de la rodilla
Article in several languages: español | English
Resumen
Con la osteotomía en un solo nivel, se puede lograr la corrección del eje de la extremidad en pacientes con deformidades combinadas femoral y tibial, pero de forma simultánea generará una alteración patológica de oblicuidad de la interlínea articular, lo que conducirá a elongación ligamentaria, inestabilidad, degeneración condral y, en última instancia, comprometerá su sobrevida y los resultados funcionales. En virtud del análisis de la literatura más reciente, podemos concluir que existe un número significativo de pacientes que requieren de un procedimiento combinado para lograr un objetivo biomecánico óptimo. La finalidad de una osteotomía en doble nivel alrededor de la rodilla consiste en restablecer la anatomía normal, descargar el compartimiento afectado, normalizar los ángulos mecánicos y la orientación de la interlínea articular. Los ejes fisiológicos pueden restablecerse a través de un análisis preoperatorio exhaustivo, respetando principios biomecánicos y fijación estable con placas bloqueadas. Es un procedimiento demandante y con indicaciones en evolución, que progresivamente se ha instaurado como una alternativa de tratamiento justificada en estudios clínicos y biomecánicos para el manejo de deformidades severas alrededor de la rodilla.
Palabras Clave
línea de Mikulicz - oblicuidad de la interlínea articular - osteotomía en doble nivel - osteotomía femoral distal - osteotomía tibial proximal - osteotomía alrededor de la rodillaPublication History
Received: 20 August 2021
Accepted: 20 June 2022
Article published online:
03 October 2022
© 2022. Sociedad Chilena de Ortopedia y Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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