Clinical Scorecard: Torsional Deformity Masquerading as Knee Instability

At a Glance

Key Highlights

• Patient presented with chronic anterior knee pain and gait dysfunction despite normal knee imaging.
• Significant axial malalignment identified via computed tomography and EOS imaging.
• Three-dimensional gait analysis revealed dynamic multiplanar abnormalities.
• Surgical correction resulted in resolution of pain and normalization of gait mechanics.
• LETA is an underrecognized cause of anterior knee pain in adolescents.

Guideline-Based Recommendations

Diagnosis

• Consider lower extremity torsional abnormalities in adolescents with unexplained knee pain.
• Utilize three-dimensional gait analysis for comprehensive assessment.

Management

• Initial conservative management may include physiotherapy and bracing.
• Surgical intervention may be necessary for persistent symptoms.

Monitoring & Follow-up

• Follow-up assessments should include objective gait analysis and patient-reported outcomes.

Risks

• Failure to recognize LETA may lead to prolonged pain and functional limitations.

Patient & Prescribing Data

Adolescents with normal intra-articular imaging but significant knee pain.

Surgical correction can lead to significant improvement in symptoms and function.

Clinical Best Practices

• Maintain a high index of suspicion for rotational malalignment in knee pain cases.
• Incorporate advanced imaging techniques for accurate diagnosis of torsional deformities.

References

• JBJS Article