Die tibiale Derotationsosteotomie bei Kniegelenkspathologien: Indikationen, Operationstechnik und Übersicht über die aktuelle Literatur

Pathological torsions of the femur and tibia are common. The negative effects on the knee are evident and do not only affect the patellofemoral joint. The suspected diagnosis of maltorsion is generated by physical examination and verified by tomographic imaging (MRI or CT). The literature review regarding tibial derotation osteotomies conducted by the authors yielded 35 studies (1562 osteotomies). Almost all of the studies reported a significant improvement compared to preoperatively based on patient-reported outcomes (Kujala, SF-36, Lysholm, KOOS, VAS and general patient wellbeing). Due to the lack of comparative studies, the best surgical technique for tibial derotation osteotomy is still undetermined. For complex cases in which deformities in several body planes are to be corrected (e.g., maltorsion and valgus varus deformity), three-dimensional planning and implementation using patient-specific incision blocks seems promising.