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<p>The alignment of the lower extremity in the frontal plane, the so-called coronal alignment, affects the peripheral ligamentous structures and thus the stability of the knee joint. Due to the altered load distribution, coronal malalignment (varus or valgus deformities) increases the stress on the affected compartment and the contralateral collateral ligament complex, which can impair the structural integrity of the collateral ligaments and their reconstructions. Varus/valgus malalignment increases the loads on the lateral/medial collateral ligamentous structures, promoting chronic lateral/medial instability and influencing its severity. In the presence of chronic peripheral instability, possible coronal malalignment should therefore be assessed and—if necessary–considered in the decision-making and treatment strategy, as neutralizing osteotomies are a&#xa0;potent biomechanical tool for soft tissue balancing. In cases of chronic lateral/medial instability accompanied by varus/valgus deformity, a&#xa0;neutralizing corrective osteotomy may be considered before or in combination with reconstruction of the lateral/medial collateral ligament to protect the reconstruction and increase its likelihood of success.</p>

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Koronares Malalignment bei peripherer Bandinstabilität: Biomechanik, Indikation und Korrekturplanung

  • 期刊论文

  • 发表日期：

    2026年6月26日

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  • Christian Peez,
  • Christoph Kittl,
  • Florian B. Imhoff,
  • Timo Tondelli

摘要

The alignment of the lower extremity in the frontal plane, the so-called coronal alignment, affects the peripheral ligamentous structures and thus the stability of the knee joint. Due to the altered load distribution, coronal malalignment (varus or valgus deformities) increases the stress on the affected compartment and the contralateral collateral ligament complex, which can impair the structural integrity of the collateral ligaments and their reconstructions. Varus/valgus malalignment increases the loads on the lateral/medial collateral ligamentous structures, promoting chronic lateral/medial instability and influencing its severity. In the presence of chronic peripheral instability, possible coronal malalignment should therefore be assessed and—if necessary–considered in the decision-making and treatment strategy, as neutralizing osteotomies are a potent biomechanical tool for soft tissue balancing. In cases of chronic lateral/medial instability accompanied by varus/valgus deformity, a neutralizing corrective osteotomy may be considered before or in combination with reconstruction of the lateral/medial collateral ligament to protect the reconstruction and increase its likelihood of success.