French Innovations That Became Gold Standards in Lower Limb Joint-Preserving Surgery: Trochleoplasty, the Scarf Osteotomy and Its Derivatives, Antero lateral procedures in ACL Reconstruction and Meniscal Preservation.

French orthopedic surgeons have played a major role in the development, evaluation, and dissemination of numerous techniques and concepts in conservative orthopedic surgery. In lower-limb surgery, the French contribution has been particularly influential in establishing strong concepts based on the critical assessment of surgical outcomes. Over time, these concepts have gained broad acceptance because of their clinical relevance, reproducibility, and effectiveness, and have contributed to standardizing the management of several orthopedic conditions. Four major concepts are addressed in this article: the comprehensive management for correction of severe objective patellofemoral instability; the correction of adult forefoot deformities; improved control of rotational knee instability through anterolateral reconstruction combined with anterior cruciate ligament reconstruction; and the principles of meniscal preservation and conservation. These concepts illustrate how French orthopedic surgery has contributed not only to the development and refinement of surgical techniques, but also to the emergence of broader treatment philosophies and decision-making frameworks that have influenced contemporary orthopedic practice. This article results from a collaborative effort among French surgeons who were trained in these concepts, contributed to their development and dissemination, and continue to apply them in daily clinical practice. Level of evidence: V; expert opinion.