Home > Traditional Approaches > Knee reconstructions

Knee reconstructions

It is very important that we have skilled technicians who can screw and plate and repair and save injured limbs. I have been in practice for 18 years and have concern at the knee reconstructions done just to attempt to achieve improvements in function. When knee ligaments are tightened with good intentions, the patient will subsequently stand with their knee flexed, unable to straighten it and walk correctly. Tightening ligaments does not correct knee function and assist in lateral stability, instead their function is made worse.

Figure (a) below is from an information handout supplied by the surgeon to one young lady who underwent a combination of procedures, a lateral release (cutting soft tissue) and a shift of the patella-tibial attachment on her left knee. The section of bone with the attachment is cut and shifted sideways to try and achieve correct tracking of the kneecap. The screws came loose and she required further surgery. She was upset because after a time of pain and crutches, it had not worked but made her patella mistracking worse. She was pleased that she had resisted pressure to also have the right one done at the same time.

When she presented to me she stood like this illustration figure (b), with turned in legs and knee joints. The surgery cannot be successful when the knee is treated in isolation rather than as part of the entire limb. This patients foot rolled and the knee joint turned inwards on each step so the knee alignment was dynamic, ever changing until I realigned the foot to realign the entire leg and achieve correct knee joint alignment.

Knee reconstructions cannot achieve healthy function and provide stability. If surgery is needed to repair serious injury a conservative approach should be taken and no modifications carried out. Correct alignment and stability can only be achieved by the less invasive approach of realigning the entire limb from the ground up.

Menosectomy <- Previous page | Next page -> Knee replacement/osteotomy