Double-Level Osteotomy for Complex Knee Deformities: Technical Description
DOI:
https://doi.org/10.63403/re.v33i1.461Keywords:
Indications, Joint Preservation, Double-Level Osteotomy, Distal Femoral Osteotomy, High Tibial OsteotomyAbstract
Double-level osteotomy (DLO) represents a surgical alternative for the treatment of complex femorotibial deformities, in which single-level osteotomies may lead to alterations in joint line obliquity and increased ligamentous overload. The aim of this study is to describe the surgical technique of double-level osteotomy for the correction of complex femorotibial deformities and to present the initial experience in a series of cases treated using this approach.
The surgical technique used in knees with varus and valgus deformities is described. In varus cases, a medial opening-wedge high tibial osteotomy was combined with a lateral closing-wedge distal femoral osteotomy, whereas in valgus cases, lateral opening-wedge osteotomies were performed at both the tibial and femoral levels. Four young patients were included, with a mean follow-up of 18 months, in whom correction of the mechanical axis and a more physiological articular alignment were achieved, with no major complications reported during follow-up.
Double-level osteotomy is presented as a reproducible and safe technique for the correction of complex femorotibial deformities, allowing restoration of appropriate anatomical and functional alignment without compromising joint line obliquity, within the context of an initial experience.
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Copyright (c) 2026 Luis I. Vivas, Wester Mendoza, Matías Medus, Francisco Pazos, Pablo Rainaudi, Rodrigo Maestu
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This work is published under a Creative Commons Attribution–NonCommercial–ShareAlike 4.0 International License (CC BY-NC-SA 4.0). The authors retain the copyright.
