Knee Malalignment

This chapter will provide a broad overview on clinically relevant topics regarding knee malalignment. The most faced knee pathology related to the topic is osteoarthritis as a result of compartment overload secondary to mechanical axis deviation. Osteotomy to offload the diseased compartment is widely performed with good success. The importance of realignment surgeries in combination with meniscal transplant, meniscal repair, cartilage restoration surgery, and ligament reconstruction has recently regained interest. To illustrate the principals of realignment osteotomy, this chapter will outline the basic biomechanics of the lower limb during activity and how knee alignment is a crucial component to consider when making clinical decisions to treat patients with complex knee pathology and associated malalignment. Surgical indications will be outlined and important considerations regarding patient selection will be covered to assist with optimal decision-making.