Osteotomy prior to total knee arthroplasty: optimizing limb alignment
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- Surgical techniques for corrective osteotomies: which one to choose?
- Preoperative planning for corrective osteotomies and TKA
- Extraarticular osteotomies and TKA: one- or two-stage procedure?
- Internal fixation: intramedullary nailing and plate fixation
- External fixation
- Limb deformity correction after TKA: making a fresh start
- Conclusions
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Contributing experts
This series of articles was created with the support of the following specialists (in alphabetical order):
Friedrich Boettner
Hospital for Special Surgery
New York, USA
Brian P Chalmers
Hospital for Special Surgery
New York, USA
Austin T Fragomen
Hospital for Special Surgery
New York, USA
The authors thank Antia Rodriguez-Villalon and Laura Kehoe, medical writers at AO Innovation Translation Center, Switzerland, for contributing to the writing and editing of the articles.
References
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