Valgus Knee-Medial Ligament Advancement

This should be done when medial ligaments are too lax, after complete release of lateral ligaments, it is performed only after final implantation of all total knee components, just before wound closure

Procedure 1:

◆ Elevation of the femoral origin of the medial collateral ligament.

◆ Proximal advancement using a locking-loop type of suture within the substance of the ligament.

◆ This suture is secured around a screw and washer with a staple placed at desired site on medial epi-condyle.

Fig 19-1 Krackow, Thomas, and Jones technique for ligament or tendon fixation to bone

Fig 19-2 The epicenter is determined, and the flap is manipulated anteriorly and proximally to re-establish the epicenter for the soft-tissue center or screw ligament-washer combination.

Procedure 2:

◆ Attachment of the medial collateral ligament at the medial epicondyle is identified

◆ Elevation of the square bone plug and locked loop sutures in the medial collateral ligament.

◆ The ligaments are pulled using the pull through technique.

Fig 19-3 Attachment of the medial collateral ligament at the medial epicondyle is identified

Fig 19-4 Elevation of the square bone plug and locked loop sutures in the medial collateral ligament.

Fig 19-5 The ligaments are pulled using the pull through technique.

20170117 Joint Information 2017-19.pdf