Plateau Side Defect Solution For Varus Knee Deformity

When the distance between the tibial plateau and the defect side is greater than 12mm, the lateral positioning osteotomy with a light defect of 8-10mm should be selected, as shown in the figure below.

Let's look at the classification of tibial plateau defects:

TYPE I: The tibial metaphyseal cortex remains intact (inclusive defect)

TYPE II A: Unilateral plateau defect

TYPE II B: Complete absence of unilateral tibial plateau

Type III: Severe bone defect in the proximal tibia (incomplete cortex above the tibial tubercle and fibular head)

Our solutions

A: Release the soft tissue first

1. Medial soft tissue release: release the superficial layer of the MCL—the attachment part of the goosefoot—the posteromedial surface of the plateau.

2. Remove medial osteophytes.

3. Remove the posterior osteophytes and release the posterior joint capsule.

4. The normal bone in all aspects of the posterior condyle can be further excised to facilitate prosthesis implantation.

Noted: The inner release cannot be done in one step! To test while loosening!

B: Solutions for plateau defects include:

1. Defect <3mm, filled with bone cement;

2. Defect > 3mm, screw piling.

3. Defects> 4mm, bone graft/metal spacer + extension rod

4. Customized prosthesis.