Osteotomies in the Multiple Ligament Injured Knee: When Is It Necessary?

The multiple ligament-injured knee is a complex injury requiring a comprehensive and thorough evaluation prior to tailoring an appropriate treatment plan. Surgical repair and reconstruction of the involved ligaments are frequently discussed in the literature; however, osteotomy to correct limb malalignment may be just as important to obtaining a good outcome. Limb realignment must be carefully evaluated and treated. Isolated soft tissue procedures are prone to failure if significant malalignment, deformity, and thrust are ignored. In select cases, osteotomy can lead to restored mechanical stability, optimal joint load distribution, improved survival of simultaneous soft tissue procedures, and better patient outcomes.