Simultaneous Bilateral Knee Valgus Stress Radiographic Technique

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Simultaneous Bilateral Knee Valgus Stress Radiographic Technique Matheus Rocha de Aguiar, M.D., Luiza B. Horta Barbosa, M.D., Márcio B. Ferrari, M.D., Nicholas I. Kennedy, M.D., Jacqueline Vieira de Castro, P.T., Ph.D., João L. Ellera Gomes, M.D., Ph.D. Arthroscopy Techniques Volume 6, Issue 6, Pages e2119-e2122 (December 2017) DOI: 10.1016/j.eats.2017.08.032 Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 1 With the patient in supine position and with both limbs extended, the patient is asked to keep both knees together. After this, a Velco strip (yellow arrows) is placed around the knees at the patellar level, maintaining both thighs in contact. Arthroscopy Techniques 2017 6, e2119-e2122DOI: (10.1016/j.eats.2017.08.032) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 2 Following the application of the strip around the knees, (A) a wedge device (white arrow) is used on the distal aspect of the limb. (B) The base of the wedge is placed below the medial malleolus (blue arrows). Arthroscopy Techniques 2017 6, e2119-e2122DOI: (10.1016/j.eats.2017.08.032) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 3 The final position of our technique is shown. The blue arrows show the direction of the forces that the Velcro belt is applied to the knee, keeping the medial aspect of both thighs in close contact. The yellow arrows show the direction of the forces that the wedge device is applied to the ankles. The final force vector simulates the valgus stress produced manually with standard radiographic techniques. Arthroscopy Techniques 2017 6, e2119-e2122DOI: (10.1016/j.eats.2017.08.032) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 4 The valgus stress radiograph performed with our technique allows the evaluation of the distance between the medial femoral condyle and the medial tibial plateau (yellow arrows). (L, left; R, right.) Arthroscopy Techniques 2017 6, e2119-e2122DOI: (10.1016/j.eats.2017.08.032) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions