Introduction to Valgus Knee
Valgus knee is a joint deformity which features with the outward angulation of the knee. The deformity is basically caused by the rheumatoid arthritis, posttraumatic arthritis, osteoarthritis or metabolic bone disease. The valgus knee comprises two components, a bone loss accompanied by metaphyseal remodeling and a soft-tissue contracture which consists of tight lateral structures.
In valgus knee a line which starts in the middle of the hip and runs to the middle of the ankle does not go through the knee but it runs through the outside half of the knee. This puts excessive load on this particular part of the knee and causes wear of its structures. One solution for this wear is a procedure called osteotomy. The principle of this procedure is to realign the leg. This way the line that connects the middle of the hip and the middle of the ankle will actually run through the middle of the knee and the load will be divided and carried by both halves of the knee equally.
The Surgery for Valgus Knee
The goal of the surgery is to restore the alignment of the knee, the joint line, the stability of the joint and its range of motions.
Prior the surgery the doctor performs multiple radiographs of the affected knee which will help him/ her evaluate the type of valgus knee and plan the surgery. After they are admitted to the hospital patients are operated the very day. They are forbidden to eat or drink anything for approximately 6 hours prior the surgery.
The surgeon first performs an arthroscopic examination of the joint. This is performed under general anesthesia and during the procedure makes necessary corrections. What follows is placement of a specific size of bone wedge in the upper part of the leg just above the knee. The bone is fixed with a plate and screws and the procedure lasts approximately 1 hour. There are no braces or plaster just bandage which is removed on the third day after the surgery. Patients may start moving their legs immediately. The drainage tubes stay in the wound for one day.
After the surgery patients are explained specific exercises by physiotherapist. These exercises are a significant part of proper rehabilitation. In the beginning patients will use crutches for walking trying not to put much pressure onto the operated knee.
Possible complications of this surgical procedure include bleeding and infections. In case of surgery failure patients will undergo additional surgeries or bone grafts. The plate which is used to fix the bone is actually beneath the skin and it may irritate the overlying soft tissues. The plate may also restrict the range of motions. If there are problems like these the plate will need to be removed. The improvement after the operation is gradual and it lasts approximately a year.