ABSTRACT
Medial compartment arthritis of the knee is a common problem that is typically associated with varus alignment and a weight-bearing axis that lies in the medial compartment. Knee flexion or hyperextension deformity or ligamentous instability may also be present. The young patient who is not an ideal candidate for total knee replacement may benefit from proximal tibial osteotomy for pain relief. The Ilizarov method with the Taylor Spatial Frame (TSF) (Smith and Nephew Inc., Memphis, TN) is a powerful tool for accomplishing proximal tibial deformity correction. A specialized feature of the TSF is its virtual hinge that allows for the simultaneous correction of multiplanar deformities and the stabilization of the ligament deficient knee. The power of the spatial frame lies in its precise control over final limb alignment and in its ability to perform a residual correction. The stability of the ringed construct permits early weight bearing and provides an ideal environment for new bone formation and a rapid healing response. Classic Ilizarov principles are followed to ensure proper frame application while the web-based computer program directs the gradual correction process. Patient involvement is crucial to the success of this technique. Computer-generated schedules and easy-to-read struts greatly simplify adjustments for patients. The most common complication is pin tract infection that is adequately treated with a course of oral antibiotics in nearly all cases. The goal of this chapter is to describe the advantageous role of this method of realignment and the basic technique used to perform the correction.
