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SLOPE CORRECTION FOR A DEFORMITY OF THE LEG AXIS

Method
Slope correction where the posterior inclination of the tibia is altered
Duration
60 to 90 minutes
Recovery time
4 to 6 months

Slope correction is a specialised osteotomy procedure for altering the backward inclination of the tibial plateau (the "posterior tibial slope"). Too steep a slope can raise the risk of a further cruciate ligament rupture or reinforce existing instability – particularly after a cruciate ligament reconstruction.

The aim of the operation is to restore a natural angle of inclination of the tibial plateau, which improves the stability of the knee joint and reduces forward translation of the tibia. Planning beforehand is based on sagittal MRI and X-ray images.

How the operation proceeds

Slope correction is typically carried out as an anterior closing or opening osteotomy, depending on the deformity, below the attachment of the patellar tendon at the tibial plateau. Depending on the technique, the correction is made by removing or opening a wedge and is secured with a locking plate. Fluoroscopy during the operation ensures correct alignment and fixation.

The procedure is usually carried out under general anaesthetic. Aftercare is guided by the stability of the fixation and by any accompanying measures (for instance a cruciate ligament revision or a meniscal repair).

Rehabilitation after a slope correction

Rehabilitation proceeds in stages in close consultation between orthopaedic surgeon and physiotherapist. The aim is to restore the function, capacity and stability of the operated knee joint step by step.

Phase I (0-6 weeks): protection and healing in
  • Partial weight-bearing with forearm crutches (15-20 kg)
  • Cooling, elevation, thrombosis prophylaxis
  • Passive mobilisation exercises (CPM), isometric exercises
Phase II (6-12 weeks): mobilisation and building up muscle
  • Increasing the load once the bone has healed reliably
  • Active movement therapy, exercise bike, strengthening
  • Co-ordination training, training the leg axis
Phase III (from week 12): functional integration
  • Sport-specific training, running and jumping training
  • Return to work and sport depending on progress
  • Assessment by functional tests (for instance jump tests)