The lateral tibiofemoral compartment has greater motion than the medial — the lateral plateau is convex and the femoral condyle rolls back significantly during flexion (posterior rollback). The lateral meniscus covers proportionally more of the tibial plateau than the medial and has more circumferential mobility due to its weaker posterior horn attachment. Lateral compartment OA is less common than medial and is associated with valgus alignment.
Lateral compartment OA from valgus alignment is treated with distal femoral osteotomy (DFO) for younger patients or TKA for older patients. Valgus knee OA with a concomitant medial ligament laxity pattern is more challenging to reconstruct with TKA and may require constrained implants.
Valgus knee OA managed with distal femoral osteotomy for younger patients or TKA for older patients with a constrained implant if significant ligament laxity.
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