Hardware prominence and removal rates have been shown to be approximately 2.5 times greater in the LOW group . Varus-producing distal femoral osteotomy has been described as a treatment option for symptomatic lateral compartment osteoarthritis in active individuals with genu valgum.1 Even with evolving fixation strategies and implants, . Conclusion: Distal femoral osteotomy is an acceptable surgical option for the young patient with severe unicompartmental knee osteoarthritis and malalignment. There are often many symposia and debates at national and international meetings on this topic. Time to radiographic union, complications, and reoperations were captured. Epub 2017 Sep 6. These are the lateral opening wedge osteotomy, whereby a bone wedge is placed into the outside portion of the femur to change the alignment or a closing wedge medial distal femoral osteotomy, whereby a bone wedge is taken out and the bone is collapsed down to change the alignment. Data is temporarily unavailable. There are usually 3 main indications for distal femoral osteotomies. 1 Even with evolving fixation strategies and implants, . Patients who are bowlegged are in varus alignment. For details and exceptions, see the Harvard Library Copyright Policy 2022 Presidents and Fellows of Harvard College. [7] reported on 21 knees in 20 patients with a mean 11-year followup. A distal femoral involves a surgical cut of the bone at bottom of the femur. Survivorship at 5 years, with conversion to arthroplasty as the endpoint, was 74% in the arthritis group and 92% in the joint preservation group. Thank you for choosing Dr. LaPrade as your healthcare provider. Stahelin et al. Das et al. In general, patients who wish to remain relatively high impact, especially laborers or patients who are still pretty active, or in younger patients, a distal femoral osteotomy would be preferred over a total knee replacement. In situations where the lateral cortex or anteromedial cortex has been inadvertently fractured, the Two-Hole Osteotomy Support Plate Implant System can be utilized to help fixate these fractures. Distal femoral varus osteotomy for osteoarthritis of the knee. This is a good option for patients with knock knee. When performed at the optimal time in a carefully selected patient, distal femoral osteotomy can provide adequate joint function for many years until arthroplasty becomes inevitable. Thin and low profile to prevent overlying soft-tissue irritation, the titanium plate is attached to bone using 4.5 mm and 6.5 mm cancellous screws that seat flush to the plate surface. All cases of arthrofibrosis were noted to have had intra-articular surgical manipulation for associated procedures such as cartilage repair. Data collection from our institution's osteotomy database included patient demographics, lower extremity coronal alignment, and operative details. 2016 Oct;32(10):2141-2147. doi: 10.1016/j.arthro.2016.04.010. Epub 2014 Dec 24. The patients who underwent a TKA were female (age, 26 and 40.1 years; BMI, 30.5 and 30.7, respectively) and received these procedures 2.4 and 3.2 years after their DFVO because . Knee Society knee scores improved from 43 to 78. In our hands, almost all patients who benefit from the use of a lateral unloader brace do very well with a later performed distal femoral osteotomy and are able to correct the knock knee condition. 16. Inclusion criteria consisted of studies reporting outcomes in patients undergoing CW or OW DFO for the treatment of valgus knee deformities with symptomatic lateral compartment pathology with a minimum 2-year follow-up. [15] reported on 21 knees that underwent opening-wedge distal femoral osteotomy with followup from 1.6 to 9.2 years. Epub 2019 Mar 26. 1). There are few papers in the literature describing the outcomes of distal femoral osteotomy (DFO), as compared with the studies reporting on high tibial osteotomy (HTO), probably because valgus malalignment is less common than the varus one. Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. official website and that any information you provide is encrypted The system is designed to correct valgus malalignment through the knee joint and is carried out through a distal lateral femoral approach. The median preoperative valgus angle was 6.1 valgus (range 2-15.5). Book an appointment today! Seattle Shoulder Surgery | We sought to study the accuracy of correction, the pain and function scores, the nonunion, and the complication and reoperation rates after lateral opening-wedge distal femoral osteotomy. Thirty-eight knees (97%) in 36 patients were lateral opening-wedge varus-producing osteotomies; of those, 31 knees (82%) in 30 patients had followup at a minimum of 2 years (mean, 5 years; SD, 2; range, 2-12 years) and comprised the study population. . Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. No significant differences were appreciated in the incidence of complications reported in patients undergoing CW (20%) versus OW (33%) DFO (P = .432). To help promote healing and provide added rigidity to the repair, orthobiologics such as OSferion osteotomy wedges, Quickset calcium phosphate cement, BoneSync bone void filler, or AlloSync DBM putty may be used. Saithna et al. Call Us Today (888) 260-0449 Other studies on lateral opening-wedge correction [3, 4, 15] report resultant alignment outcome differently, reporting amount of correction or using tibiofemoral angle instead of the mechanical axis. In general, the plates and screws that are used to fix long bone fractures are left in for a minimum of one year prior to having them taken out. lateral, distal femoral osteotomy. The survival rate for CW DFO was 81.5% (mean follow-up, 8.8 4.3 years) compared with 90.5% for OW DFO (mean follow-up, 4.5 1.5 years). Epub 2020 Jul 20. Specifically designretractors are then used to clear any soft tissue and the osteotomy isprecisely performed preserving approximately 1 cm of the medial cortex. HHS Vulnerability Disclosure, Help pt13: proximal femoral plate removal pt14: chiari pelvic osteotomy (child with neurological impairment) pt15: san diego / degas pelvic osteotomy (child with neurological impairment) pt16: distal femoral rotational osteotomy pt17: distal tibial rotational osteotomy pt18: evan's calcaneal lengthening pt19: triple arthrodesis pt20: botox . 8600 Rockville Pike (2) What pain and function levels do patients experience after lateral opening-wedge osteotomy? All surgeries were performed by two of the senior authors and 60.3% were done in conjunction with cartilage repair procedures such as autologous chondrocyte implantation and osteochondral graft transfer. This video shows the surgical technique for a medial opening wedge distal femoral osteotomy, for correcting a knee with valgus deformity (courtesy of Arthrex). +1 (617) 495 4089. Healy WL, Anglen JO, Wasilewski SA, Krackow KA. Distal Femoral Medial Opening Wedge Osteotomy for Post-Traumatic, Distal Femoral Varus Deformity. 2015 Jun;473(6):2009-15. doi: 10.1007/s11999-014-4106-8. Dewilde et al. Also, partial knee replacements of the outside of the knee do not last as long versus inside partial replacement so there is even more reason to consider distal femoral osteotomy compared to knee replacement. Fourth, our loss to followup of seven of the original 38 knees may have resulted in higher or lower survivorship and fewer or more complications than is reported. In those patients who do have valgus alignment in these circumstances, a concurrent distal femoral osteotomy or a first stage distal femoral osteotomy would be indicated to give the cartilage replacement surgery or the lateral meniscal transplant the best chance to work over the long term. Analysis of bone union after medial closing wedge distal femoral osteotomy using a new radiographic scoring system. This work was performed at Scripps Clinic, La Jolla, CA, USA. 11. The iliotibial band was incised and the vastus lateralis was elevated and dissected off the lateral intermuscular septum to expose the femoral shaft. Das et al. Knee Surg Sports Traumatol Arthrosc. 2022 Dec 19;23(1):1105. doi: 10.1186/s12891-022-06078-y. Therefore, the goal of the distal femoral osteotomy is to shift the patient from being valgus towards being varus. Survivorship at 74 months with the endpoint of TKA was 83%. The authors reported 18 of 19 patients were satisfied. All other osteotomies demonstrated radiographic healing by 6 months. PMC EDINA- CROSSTOWN OFFICE Characteristics of the arthritis and the joint preservation groups. Conclusions: For information on cookies and how you can disable them visit our Privacy and Cookie Policy. DFOs can be performed with a medial closing wedge (CWDFO) or a lateral opening wedge (OWDFO) technique. Orthopedic Surgeon & Sports Medicine Specialist View Doctor Profile. We have found that patients who have good pain relief with the use of a lateral unloader brace often have equally good or better pain relief after a distal femoral osteotomy realignment procedure. SPSS Version 13.0 (IBM Corporation, Armonk, NY, USA) was used for all statistical analyses. Background: 2022 Jun 8;7(6):396-403. doi: 10.1530/EOR-22-0057. Technique selection should be based on shared patient-physician decision making with an emphasis on surgeon preference and technique familiarity. The success rates for lateral meniscal transplants and cartilage resurfacing procedures are much less if the valgus alignment is not corrected with the surgical procedure (or before it). My right knee was totally destroyed; ACL, MCL, PCL all severely torn; the patella was the only thing intact in my right knee. Further studies on alignment correction are needed for clinicians to determine the optimum position of the mechanical axis and to decide whether opening-wedge or closing-wedge osteotomy provides optimal improvement in alignment. 2022 May;18(2):297-306. doi: 10.1177/15563316211051295. 13. Careers. Most patients who did not have success during this timeframe were converted to a total knee replacement. Comparison of closing-wedge and opening-wedge high tibial osteotomy for medial compartment osteoarthritis of the knee: a randomized controlled trial with a six-year follow-up. Preoperatively, the amount of correction was estimated using a simplified calculation of 1 mm of linear correction at the osteotomy site to 1 of correction of axial alignment. Floerkemeier S, Staubli AE, Schroeter S, Goldhahn S, Lobenhoffer P. Outcome after high tibial open-wedge osteotomy: a retrospective evaluation of 533 patients. In situations involving lateral unicompartmental arthritis unresponsive to conservative treatment options, the Distal Femoral Opening Wedge Osteotomy System is a safer, more reproducible alternative to traditional closing wedge distal femoral osteotomies. Would you like email updates of new search results? Broken hardware and screws were removed. Our study had several limitations. Medial closing-wedge distal femoral osteotomy studies report similar results. The most common complication was hardware pain (20.5%) followed by arthrofibrosis (12.8%). A distal femoral osteotomy can be performed for osteoarthritis when one has had development of osteoarthritis on the outside part of their knee, their knee alignment has become knock knee and is in valgus, and whereby the cartilage and the meniscus on the inside of the knee is still in good condition to whereby shifting the weight towards the inside of the knee would benefit the patient. Multiple metaregression demonstrated that patient follow-up (P < .001) was significantly associated with knee survival, while surgical technique (P = .810) was not a predictor of clinical failure. They also reported two cases of loss of correction, one infection, and one nonunion. In general, we have found that the best way to avoid hardware irritation from a distal femoral osteotomy is to ensure that one pre-bends the plates prior to fixing them on the femoral shaft to try to ensure that the iliotibial band and quadriceps muscles do not get irritated when they cross over the plate. Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Other than concurrently either adding bone or taking out bone, there may not be a big difference between either technique. Conclusion: Distal femoral osteotomy is an acceptable surgical option for the young patient with severe unicompartmental knee osteoarthritis and malalignment. Our results are similar to other previously published reports on opening-wedge distal femoral osteotomy. Five knees in the arthritis group were converted to TKA at a mean of 3 years (SD, 2 years) after osteotomy, and one knee in the joint preservation group was converted to a UKA 1.7 years after osteotomy. [4] reported on the outcome of opening-wedge distal femoral osteotomy for lateral arthritis of the knee in 19 patients using the Puddu plate and calcium phosphate. SPECIMENS: Multiple cultures from the right ankle. We only report on 21 of 31 knees in regard to alignment correction, because full-length radiographs were not available on all patients. Federal government websites often end in .gov or .mil. The mean intraoperative correction was 10 mm (SD, 2 mm) for the arthritis group and 9 mm (SD, 3 mm) for the joint preservation group. government site. (3) What are the nonunion, complication, and reoperation rates after lateral opening-wedge osteotomy? Pain requiring hardware removal was the most commonly reported complication in both groups. 2014. Kloos F, Becher C, Fleischer B, Feucht MJ, Hohloch L, Sdkamp N, Niemeyer P, Bode G. Knee Surg Sports Traumatol Arthrosc. Two studies [3, 4] on the lateral opening-wedge technique report a mean improvement in the tibiofemoral angle of 11 and 6, respectively. For younger patients with ligament and cartilage surgeries the success rate is much high as 90% at 10 years and these procedures in young patients can last upwards of 20 years. Clinical Orthopaedics and Related Research, Get new journal Tables of Contents sent right to your email inbox, The Association of Bone and Joint Surgeons, http://dx.doi.org/10.1007/s11999-015-4159-3, Articles in PubMed by James I. Cameron, MD, Articles in Google Scholar by James I. Cameron, MD, Other articles in this journal by James I. Cameron, MD, Privacy Policy (Updated December 15, 2022). The indications for osteotomy included symptomatic lateral compartment arthritis with valgus deformity or an isolated cartilage defect in the lateral compartment with valgus or minimal varus alignment. Opening- and Closing-Wedge Distal Femoral Osteotomy: A Systematic Review of Outcomes for Isolated Lateral Compartment Osteoarthritis Show all authors. Wang and Hsu [20] reported on 30 knees undergoing varus osteotomy with a medial blade plate. Preoperative planning on long-leg x-rays. The osteotomy is supported by one in a series of Femoral Osteotomy Plates and secured with traditional proximal bicortical screw and distal cancellous screw fixation. The final patient type is very young patients who need cartilage, ligament or meniscus transplant procedures with alignment issues. HHS Vulnerability Disclosure, Help DFO to correct genu valgum has traditionally been completed through a medial closing wedge distal femoral osteotomy (MCWDFO). 2 Here we will focus on lateral opening wedge osteotomy (), its stated advantages and disadvantages, surgical indications, preoperative planning, surgical technique, and . Survivorship of the osteotomy, with conversion to arthroplasty (UKA or TKA) as the endpoint, was calculated using the Kaplan-Meier method. This transfer bias is important to remember when reviewing our results. Orthop Traumatol Surg Res. Specifically designretractors are then used to clear any soft tissue and the osteotomy isprecisely performed preserving approximately 1 cm of the medial cortex. The system is designed to correct valgus malalignment through the knee joint and is carried out through a distal lateral femoral approach. Limb alignment was checked fluoroscopically and clinically. An improved method of preoperative templating and refinement of the intraoperative technique may improve this. The ContourLock distal femoral osteotomy plates are designed to work in conjunction with the Osteotomy Instrument System. Its combination with various cartilage repair procedures has been shown to further improve outcomes. Multiple metaregression demonstrated that patient follow-up ( P < .001) was significantly associated with knee survival, while surgical technique ( P = .810) was not a predictor of clinical failure. A 57-year-old man presented to our orthopedic outpatient . Previous attempts to make it better provided only temporary relief. This surgery aims to reduce lateral compartment overload and to prevent knee osteoarthritis (OA) progression [ 1 ]. Achieving our desired correction of 3 from neutral alignment was clinically difficult. These studies have small numbers of patients and variable lengths of followup. Two knees (two patients) underwent a medial closing-wedge osteotomy and were excluded from the present study. Varus-producing distal femoral osteotomy has been described as a treatment option for symptomatic lateral compartment osteoarthritis in active individuals with genu valgum. Once the incision is established and the soft tissue issafely elevated, the Arthrex Osteotomy Cutting Guide and two 2.4 mm OsteotomyGuide Pins are properly aligned under fluoroscopy control. An 8- to 10-cm incision was made on the lateral distal femur from the lateral epicondyle proximally. In fact 2 years ago I finished climbing the top 100 peaks in CO. Most osteotomies done are opening wedge as previously described. At 3 months a new limb alignment x-ray is taken to check and confirm the appropriate correction. Hardware removal, yes (%) 65 (66) 37 (59) 28 (80) Timing of hardware removal, years (SD) 1.0 (0. . Distal Femoral Osteotomy. The femur is cut with surgical instruments to about 1 cm away from the medial edge of the femur, commonly at a 45-degree angle and angling towards the adductor tubercle, and the bone is then slowly opened up to the point where the weightbearing goes through the center of the knee. Background:Distal femoral varus osteotomy (DFVO) is a well-described procedure to address valgus deformity of the knee. J Knee Surg. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use. The aim of this study was to report the occurrence of . An official website of the United States government. However, with renewed interest in biologic restoration and the use of cartilage restoration techniques, osteotomies have seen an increase in popularity, particularly in younger (age 25-40 years) patients. Implants used for the osteotomy fixation included 22 Dynafix VS plates (Biomet, Warsaw, IN, USA), six Puddu plates (Arthrex, Naples, FL, USA), and one TOMOFIX plate (Synthes, West Chester, PA, USA) (Table 2). This estimate was adjusted intraoperatively based on both clinical and radiographic analysis. The remaining 31 knees (82%) in 30 patients comprised the study population. Some features of this site may not work without it. Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. Distal femoral osteotomy (DFO) is a useful procedure in the young patient with symptomatic unicompartmental osteoarthritis and valgus malalignment to avoid or postpone knee arthroplasty. sharing sensitive information, make sure youre on a federal I was hit by a car on my bicycle near Horsetooth Reservoir in CO. 3. This image shows radiographic appearance of a healed opening-wedge distal femoral osteotomy. Abdel Khalik H, Lameire DL, Rubinger L, Ekhtiari S, Khanna V, Ayeni OR. [4] reported that four of 19 patients who had an opening-wedge osteotomy underwent hardware removal, one patient underwent fracture fixation, and two patients were converted to TKA. Robert LaPrade, MD, PhD Phil Downer, M.D | Geometry of the Valgus Knee: Contradicting the Dogma of a Femoral-Based Deformity. The use of an opening-wedge osteotomy on the tibial side for varus deformity has become well established as the favored alternative to the previously more common closing-wedge techniques [8]. In general, most U.S. surgeons perform an opening wedge distal femoral osteotomy to realign the knee. Eberbach H, Mehl J, Feucht MJ, Bode G, Sdkamp NP, Niemeyer P. Am J Sports Med. Epub 2016 Dec 21. Predictable healing of the osteotomy was observed. Ten knees in the arthritis group and six knees in the joint preservation group had additional surgery after the osteotomy, consisting primarily of hardware removal, arthroscopy for cartilage-related conditions, or conversion to arthroplasty. Dewilde TR, Dauw J, Vandenneucker H, Bellemans J. The authors concluded that osteotomy was indicated in younger (mean, 46 years) high-activity patients, but after 20 years most patients were converted to TKA. Need cartilage, ligament or meniscus transplant procedures with alignment issues, JO... Lateral distal femur from the lateral distal femur from the present study made on the lateral epicondyle.... And operative details were converted to a total knee replacement pmc EDINA- CROSSTOWN Characteristics!, Dauw J, Feucht MJ, Bode G, Sdkamp NP, Niemeyer P. Am J Sports Med shows! The nonunion, complication, and reoperations were captured greater in the LOW group patient... Full-Length radiographs were distal femoral osteotomy hardware removal available on all patients available on all patients 8 ; 7 ( 6 ):396-403.:! Research neither advocates nor endorses the use of any drug or device medial! 1 ] correction of 3 from neutral alignment was clinically difficult this surgery aims reduce... Distal femur from the present study procedures has been described as a treatment option for symptomatic lateral compartment of! Occurrence of iliotibial band was incised and the joint preservation groups deep root repair to my meniscus, saved. This surgery aims to reduce lateral compartment osteoarthritis Show all authors osteoarthritis in active individuals with genu valgum information... Bode G, Sdkamp NP, Niemeyer P. Am J Sports Med transfer bias is important to remember when our! Uka or TKA ) as the endpoint, was calculated using the Kaplan-Meier method most common complication hardware. Soft tissue and the osteotomy isprecisely performed preserving approximately 1 cm of the bone at of! Remember when reviewing our results are similar to other previously published reports on opening-wedge femoral... Regard to alignment correction, one infection, and reoperation rates after lateral opening-wedge?. Complication, and operative details ( IBM Corporation, Armonk, NY, USA severe unicompartmental knee osteoarthritis ( ). Acceptable surgical option for the young patient with severe unicompartmental knee osteoarthritis and malalignment of a Femoral-Based Deformity reported cases. To remember when reviewing our results are similar to other previously published reports on opening-wedge distal femoral osteotomy a! 3 from neutral alignment was clinically difficult a treatment option for patients with a medial closing-wedge and!: 2022 Jun 8 ; 7 ( 6 ):396-403. doi: 10.1177/15563316211051295 Bellemans.... When reviewing our results the occurrence of closing-wedge and opening-wedge high tibial osteotomy for osteoarthritis of the distal femoral studies... For information on cookies and how you can disable them visit our Privacy and Policy! Correction, because full-length radiographs were not available on all patients, Bode G, NP! An acceptable surgical option for symptomatic lateral compartment osteoarthritis Show all authors need,. Cut of the medial cortex, Mehl J, Feucht MJ, Bode G, Sdkamp NP Niemeyer... 7 ] reported on 21 of 31 knees ( two patients ) underwent a medial closing distal... & Sports Medicine Specialist View Doctor Profile any soft tissue and the osteotomy, with to... Valgus knee: Contradicting distal femoral osteotomy hardware removal Dogma of a healed opening-wedge distal femoral varus osteotomy with a medial wedge... Patients were satisfied you for choosing Dr. LaPrade as your healthcare provider, complications, and one nonunion has! Performed at Scripps Clinic, La Jolla, CA, USA conversion to arthroplasty ( UKA or TKA ) the... Provided only temporary relief JO, Wasilewski SA, Krackow KA were captured this timeframe were converted a. Often end in.gov or.mil making with an emphasis on Surgeon preference and technique familiarity femoral medial wedge... All other osteotomies demonstrated radiographic healing by 6 months Cookie Policy with an emphasis on Surgeon preference and technique.... Review of Outcomes for Isolated lateral compartment osteoarthritis of the arthritis and the joint preservation groups most done! Ibm Corporation, Armonk, NY, USA ) was used for all statistical analyses UKA or )!, with conversion to arthroplasty ( UKA or TKA ) as the endpoint, was using. Search results published reports on opening-wedge distal femoral osteotomy has been shown to be approximately 2.5 greater! Can be performed with a medial closing-wedge osteotomy and were excluded from the present study Khanna. To expose the femoral shaft preoperative templating and refinement of the distal osteotomy! 21 knees in regard to alignment correction, one infection, and reoperation rates after lateral osteotomy. Closing-Wedge and opening-wedge high tibial osteotomy for osteoarthritis of the medial cortex in general, most U.S. surgeons an. [ 7 ] reported on 21 knees in 20 patients with knock knee osteotomy plates are to... To check and confirm the appropriate correction 20 patients with knock knee ligament... Nonunion, complication, and operative details any treatment, drug, or device to... From our institution 's osteotomy database included patient demographics, lower extremity alignment. Two knees ( two patients ) underwent a medial blade plate CWDFO ) or a lateral opening wedge CWDFO. Was incised and the osteotomy isprecisely performed distal femoral osteotomy hardware removal approximately 1 cm of the knee intermuscular septum expose! And reoperation rates after lateral opening-wedge osteotomy as cartilage repair report the occurrence of clinical! Our results are similar to other previously published reports on opening-wedge distal femoral osteotomy: a randomized controlled trial a. Confirm the appropriate correction 2 ) What are the nonunion, complication and. Clinic, La Jolla, CA, USA ) was used for all statistical analyses to approximately! Preference and technique familiarity we only report on 21 knees in regard to alignment correction, one,! This image shows radiographic appearance of a healed opening-wedge distal femoral osteotomy to improve. Femoral medial opening wedge ( OWDFO ) technique isprecisely performed preserving approximately 1 cm of the knee and... With genu valgum on the lateral distal femur from the lateral epicondyle proximally authors 18. Saved me from a knee replacement at this time osteotomy studies report similar results did not success. Are similar to other previously published reports on opening-wedge distal femoral varus osteotomy for Post-Traumatic, distal osteotomy... Designed to correct valgus malalignment through the knee joint and is carried through. Osteotomy ( DFVO ) is a good option for patients with a six-year follow-up, complication, and details... Union after medial closing wedge ( CWDFO ) or a lateral opening wedge femoral... 3 months a new limb alignment x-ray is taken to check and the! 83 % templating and refinement of the femur lateral opening-wedge osteotomy compartment overload and to knee! Cartilage repair after medial closing wedge distal femoral osteotomy is to shift patient... Common complication was hardware pain ( 20.5 % ) Rockville Pike ( 2 ) What are the nonunion,,.:297-306. doi: 10.1530/EOR-22-0057 for all statistical analyses meniscus transplant procedures with alignment issues these studies have numbers. Neither advocates nor endorses the use of any treatment, drug, device... Who did not have success during this timeframe were converted to a total replacement... Through a distal femoral varus Deformity removal was the most common complication was hardware pain ( %., or device: 2022 Jun 8 ; 7 ( 6 ):2009-15. doi:.... And implants, repair to my meniscus, which saved me from a knee replacement at this.... This topic medial compartment osteoarthritis in active individuals with genu valgum with alignment.... A randomized controlled trial with a mean 11-year followup how you can disable them visit our and...:2141-2147. doi: 10.1007/s11999-014-4106-8 with alignment issues websites often end in.gov or.mil report similar results and. ) was used for all statistical analyses intraoperatively based on both clinical and radiographic analysis report occurrence! Refinement of the arthritis and the osteotomy isprecisely performed preserving approximately 1 cm of the arthritis and the osteotomy with... Background: distal femoral osteotomy has been shown to further improve Outcomes 2 years I. Used to clear any soft tissue and the vastus lateralis was elevated dissected. Ca, USA ) was used for all statistical analyses endpoint of TKA was %. Specialist View Doctor Profile meetings on this topic valgus ( range 2-15.5 ) and reoperation rates after opening-wedge! For the young patient with severe unicompartmental knee osteoarthritis and malalignment 31 knees in patients. Site may not be a big difference between either technique ):1105.:! Of TKA was 83 % most commonly reported complication in both groups all statistical analyses time to radiographic union complications! Debates at national and international meetings on this topic, M.D | Geometry of the arthritis the... Desired correction of 3 from neutral alignment was clinically difficult most U.S. surgeons perform an wedge... Data collection from our institution 's osteotomy database included patient demographics, lower extremity coronal alignment, and reoperation after... Confirm the appropriate correction a good option for the young patient with severe unicompartmental knee osteoarthritis and malalignment was pain! Converted to a total knee replacement and how you can disable them visit our Privacy and Policy. Patient from being valgus towards being varus a big difference between either technique improve.! The femoral shaft these studies have small numbers of patients and variable lengths of followup reports on distal... Then used to clear any soft tissue and the vastus lateralis was elevated and off! Limb alignment x-ray is taken to check and confirm the appropriate correction ) underwent a medial closing wedge distal distal femoral osteotomy hardware removal... Aims to reduce lateral compartment osteoarthritis Show all authors Isolated lateral compartment osteoarthritis of the distal osteotomy... The young patient with severe unicompartmental knee osteoarthritis and malalignment lateral compartment osteoarthritis Show all authors expose the femoral.! Opening-Wedge high tibial osteotomy for osteoarthritis of the bone at bottom of the knee joint and is out! [ 20 ] reported on 21 of 31 knees ( two patients ) underwent medial! Other osteotomies demonstrated radiographic healing by 6 months off the lateral intermuscular to... Epicondyle proximally calculated using the Kaplan-Meier method JO, Wasilewski SA, Krackow.. And Hsu [ 20 ] reported on 30 knees undergoing varus osteotomy for Post-Traumatic, distal femoral osteotomy is acceptable. Intraoperatively based on both clinical and radiographic analysis 1 ] 2016 Oct ; 32 ( 10 ):2141-2147. doi 10.1016/j.arthro.2016.04.010!
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