PMC8205600_01
Standing full leg axis radiographs in orthopedic boots of both sides show a severe varus deformation of about 30  (a) and 17  (c) and the postoperative outcome with an almost neutral leg axis (b, d).
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fig1
Preoperative standing full leg X-rays demonstrate a severe varus malalignment of 30  right and 17  left (Figures 1(a) and 1(c)). The postoperative X-rays with an almost neutral leg axis (remaining varus of 3  right and 2  left) are shown in Figures 1(b) and 1(d).  Figure 3 shows a close-up of the pre- and postoperative status of the right knee in two planes.
Intraoperative situation after insertion of the cone. Note how the asymmetric design bridges the extensive medial bone defect.
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fig2
An asymmetrical cone was used to reconstruct the medial tibial plateau (Figure 2).
Gonarthritis IV  and completely impacted medial tibial plateau with small diffuse bony remains (a, c). Postoperative standing antero-posterior and lateral X-ray of the right knee. Pay attention to the asymmetric tibial cone which reconstructs the medial tibial plateau (b, d).
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fig3
The postoperative X-rays with an almost neutral leg axis (remaining varus of 3  right and 2  left) are shown in Figures 1(b) and 1(d).  Figure 3 shows a close-up of the pre- and postoperative status of the right knee in two planes.