Alterations in the mechanical axis and anatomical knee, are frequently accompanied by knee pain and functional limitation, they tend to worsen over time and are a common cause of joint degeneration (osteoarthritis knee), with a mechanism of concentration of load and cutting forces on limited areas of the articular surface.

Most common knee misalignment mainly varus knee (‘O’ legs, or jockey legs), valgus knee(‘X’ legs), recurvatum knee (deformities with anterior concavity) and procurvatum knee (deformity with rear concavity).

When axial alteration is goniometrically measured, if deviation from the norm is 10 to 25 degrees, surgery with corrective osteotomy can be indicated (with the aid of metal plates and screws) ‘in plus’ or in ‘subtraction’, femoral or tibial, that -together with the use of articulated braces and Passive Continuous Motion devices- allow early discharged mobilization and help to maintain muscle tone (agonists versus antagonists) and articular proprioception during osteotomy healing, with very satisfactory results in the short, medium and long term.

Beyond the above mentioned degrees of deformity, correction of misalignment joints must be pursued with the use of percutaneous osteotomy with a circular bone fixation device (Ilizarov method), uniaxial or biaxial (Monotube, Castman, De Bastiani, etc.).