Review Question - QID 1109

This patient presents with asymmetric gapping because she is tight in extension and balanced in flexion. Ries discusses that resection of the proximal tibia in this situation is a common pitfall in surgical technique as it “will resolve the flexion contracture but produce instability in flexion”. The preferred method of restoring the distal femoral joint line to achieve full extension and maintain flexion stability is to cut “more of the distal part of the femur, as this will not affect the flexion space”. Similarly, there is an asymmetric gap if full extension is achieved, but flexion is limited. The lack of full flexion can be treated with distal femoral augments and a thinner tibial insert.