Ligament Deficiency With Mal Alignment

Abstract

SUMMARY

In caring for active middle aged patients with a knee ligament deficiency, orthopedic surgeons must consider several variables not present in younger patients. Besides the specific ligament deficiency, practitioners must also consider alignment, or mal alignment, and degenerative changes of the knee. These factors may exacerbate the symptoms of ligament deficiency or they may impact the therapeutic intervention. Diagnostic tools include a detailed history, thorough physical examination, and imaging modalities. Several operative options are available depending on the specific pattern of pathology. These options include ligament reconstruction, osteotomies, or meniscus transplantation in various combinations. In this article, ligament injuries in middle aged athletic patients in which alignment plays a role are reviewed, and diagnostic and therapeutic options for their management are offered. Also, emphasized are the more common anterior cruciate ligament deficiency with varus mal alignment and the less common posterior cruciate ligament deficiency with medial compartment arthrosis.