Knee malalignment

Regaining alignment

When your limbs are malaligned, it can lead to other problems within the knee such as dislocation, cartilage or meniscal injury and osteoarthritis. The condition can occur in both athletic and non-athletic individuals, though running and high-impact sports will exacerbate painful symptoms.

If you have been diagnosed with knee malalignment, we work with you to find the right option to give you the best-possible outcome.

Conservative treatment of knee malalignment

If your knee malalignment isn't having a tremendous impact on your quality of life, you may wish to try conservative treatment methods before deciding to undergo surgery. Non-surgical methods of treatment will require you to discontinue activities that exacerbate syspoms. Try to limit exercises that could cause excessive wear and tear on the knee.

Swap high-impact or contact sports, such as running, football, rugby or tennis, for low-impact sports like swimming, walking, elliptical training or yoga. High-impact sports put stress on your joints and if you're experiencing knee malalignment this will increase the wear to the joint. Low-impact sports put much less stress on the joints so are highly recommended as an alternative.

Anti-inflammatory medication, such as ibuprofen, can help to alleviate pain and swelling. Physiotherapy can also be beneficial as effective strength training exercises can help to strengthen the muscles around the knee assisting in stability.

Conservative treatment methods

At Schoen Clinic London, our knee Specialists will always aim to preserve the natural knee joint for as long as possible before undergoing knee replacement surgery.

Non-surgical treatments for knee malalignment:

  • Lifestyle changes (limiting high-impact sports)
  • Anti-inflammatories
  • Physiotherapy

Surgical treatment of knee malalignment

We believe in improving the situation rather than rushing in with unnecessary surgery. However, if conservative methods of treatment have failed to improve the situation and knee pain continues, it's time to consider surgical options.

Malalignment patients with persistent knee pain will need mechanical correction of the malaligned knee joint. The surgical option for malalignment is an osteotomy procedure to realign the bones into a stable position with metal plates and screws, reducing the stress, wear and tear on the joint. Both arthritis and instability can be improved by correcting the alignment of the knee.

There are three types of knee osteotomy used for knee malalignment:

  • High Tibital Osteotomy (HTO) - This surgery involves a partial cut to the top of the shin bone (the tibia) to realign the bone and stabilise the knee joint. A high tibial osteotomy is usually suggested for painful arthritic knees or unstable knees.
  • Femoral Osteotomy - This surgery involves a partial cut to the bottom of the thigh bone (the femur) to realign the bone and stabilise the joint.
  • Tibial Tubercle Osteotomy (TTO) - This surgery is used for  patients with patellar instability and involves a partial cut to the top of the shin bone where the patellar tendon inserts on the bone. TTO surgery helps to unload a persistently painful knee cap and stabilises knee caps that are prone to dislocation.

Surgical treatment methods

  • High Tibital Osteotomy (HTO)
  • Femoral Osteotomy
  • Tibial Tubercle Osteotomy (TTO)

High tibial osteotomy vs. knee replacement surgery

In some cases, knee osteotomy procedures have advantages over knee joint replacement as they can reduce the associated knee pain and preserve the joint. An osteotomy is generally preferred for younger patients as it allows them to maintain an active lifestyle for many years, extending the lifespan of the natural knee joint and delaying the need for a knee replacement.