Osteotomies Around the Knee in Ligament Injuries

Ligament injuries and reinjuries are common around the knee joint. An important factor that is often neglected in managing these is the alignment of the lower limb in sagittal, coronal and rotational planes. The cruciate ligament biomechanics are significantly affected by tibial slope and varus/valgus alignment has a major effect on the forces on the medial and lateral collateral ligaments (LCLs). Altering these alignment factors can have a favourable effect on corresponding ligament injuries/reinjuries. In this chapter, we will look at the biomechanics of malalignment and ligament injuries and how a ligament deficiency can be managed by an osteotomy either as a stand-alone procedure or along with a ligament reconstruction, including a review of the latest evidence.