The procedure of the preoperative knee osteotomy

1. Take X-ray Images
2. Determine Deformity - Alignment Analyse
3. Determine Angles for Osteotomy - Miniaci
4. Partial Osteotomy (Hinge reserved) + Stable Internal Fixation

a. Full X-ray images in weigth-bearing position

b. Knee X-ray images in weight - bearing position

Assement of lower extermity alignment

a. check the mechanical Axis and Anatomical Axis

b. determine the joint centers

c. check the joint orientation line and angle

d. malalignment test - check the MAD or MTA

Mechanical Axis

• It is defined as the straight line connecting the joint center points of the proximal and distal joints.
• The mechanical axis is always a straight line, whether in the frontal or sagittal plane.

Anatomic Axis

• The anatomic axis of a bone is the mid-diaphyseal line
• the anatomic axis line may be staight in the frontal plane but curved in the sagittal plane, as in the femur.