2016 Jun 6;4(6):2325967116649901. doi: 10.1177/2325967116649901. 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. 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. Download Citation | Biomechanical study of the stiffness of the femoral locking compression plate of an external fixator for lower tibial fractures | Background: A locking compression plate (LCP . Distal Femoral Osteotomy vlog: Hardware removal - YouTube Last vlog!My blog: https://orbite-beast.tumblr.com/ Last vlog!My blog: https://orbite-beast.tumblr.com/. I can run, bike, & climb mountains. 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. 17. In total, we included 23 retrospective studies (n = 619 knees), of which 10 studies (n = 271 knees) reported outcomes after CW DFO and 13 studies (n = 348 knees) reported on OW DFO outcomes. A sterile tourniquet was used. Medial closing-wedge osteotomy A medial-side distal femoral approach is normally used with a skin incision starting 2 cm distal to the medial epicondyle and extending 15 cm proximally. 2019 Jul;38(3):351-359. doi: 10.1016/j.csm.2019.02.004. Although TKA narrowed the indications for this once-common procedure, the femoral osteotomy remains a reasonable treatment for many patients with limb deformities [7, 25], and is broadly indicated when there is a deformity resulting in malalignment of the hip and lower . Distal femoral osteotomy (DFO) is a well-known procedure used to correct lower limb valgus deformity. Epub 2022 Jun 8. Postoperative management included touchdown weightbearing for 6 weeks with no limits to ROM followed by 4 to 6 weeks of progressive weightbearing with the use of crutches. . Some distal femoral osteotomies involve taking out bone where you let the leg compress on itself, this is called a closing wedge distal femoral osteotomy. One nonunion occurred in the arthritis group (3%) and was treated with refixation and grafting (Figs. The best way to determine the success rate of distal femoral osteotomies is to assess the success rate in systematic reviews in the peer-reviewed literature. There is still debate as to what the correct indication is and which surgical techniques lead to the best outcomes in performing a DFO. a Preoperative long-leg standing X-rays. Keywords: A five-to-11-year follow-up study. The system is designed to correct valgus malalignment through the knee joint and is carried out through a distal lateral femoral approach. Preoperatively, all patients underwent complete radiographic evaluation including full-length, standing AP radiographs of bilateral lower extremities (some radiographs were done at outside institutions and were not available for alignment measurements for this study). EFORT Open Rev. Duivenvoorden T, Brouwer RW, Baan A, Bos PK, Reijman M, Bierma-Zeinstra SM, Verhaar JA. Distal femoral varus osteotomy for painful genu valgum. The distal femoral cortex was removed to expose 80 mm of the distal portion of the revision femoral stem. Sternheim et al. In the joint preservation group, the mean IKDC total score improved from 36 (SD, 12) preoperatively to 62 (SD, 18) postoperatively. Conclusion: Distal femoral osteotomy is an acceptable surgical option for the young patient with severe unicompartmental knee osteoarthritis and malalignment. Good to excellent clinical outcomes were reported in PROMs when compared with preoperative values with both techniques, while no significant differences between techniques were appreciated on functional Knee Society Scores and Tegner scores. OSferion wedges are intended to be used in conjunction with the distal femoral and high tibial opening wedge osteotomy plates and screws to promote healing and provide added rigidity to the repair. Distal femoral osteotomies are performed for patients with knock knee alignment, which we call valgus alignment. Disclaimer, National Library of Medicine sharing sensitive information, make sure youre on a federal 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. There are usually 3 main indications for distal femoral osteotomies. Clin Sports Med. Lateral Opening-wedge Distal Femoral Osteotomy: Pain Relief, Functional Improvement, and Survivorship at 5Years. In patients who have chronic MCL tears that are symptomatic, the peer reviewed literature notes that the patients who are in valgus alignment have a much higher risk of having their future MCL reconstruction graft procedure stretch out unless the malalignment is corrected with a distal femoral osteotomy. Broken hardware and screws were removed. The study population was stratified into two groups based on reason for osteotomy: patients with isolated symptomatic lateral compartment arthritis (arthritis group; 19 knees [61%]) and patients who underwent joint preservation procedures including osteochondral allograft transplantation or meniscal allograft transplantation (joint preservation group; 12 knees [39%]) (Table 1). The second is in patients who have arthritis on the outside of the knee and are too young for a standard partial knee replacement. 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. Full weightbearing was allowed at radiographic evidence of healing, typically between 8 and 16 weeks (Fig. Healy WL, Anglen JO, Wasilewski SA, Krackow KA. 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. Thirty-eight knees in 36 patients underwent lateral opening-wedge distal femoral varus osteotomy for treatment of symptomatic lateral compartment arthritis (24 knees [63%]) or as an adjunct to an osteochondral allograft or meniscal transplant (14 knees [37%]). 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. Distal Femoral Osteotomy. Some error has occurred while processing your request. Once the osteotomy was mobile, an opening-wedge device was placed. 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. In general, we keep patients non-weightbearing for 8 weeks for the distal femoral osteotomy, obtain x-rays at 8 weeks to ensure there is sufficient healing, and then initiate a partial protective weightbearing program, advancing it one-quarter body weight per week until the 3-month point. OSferion is an osteoconductive bone graft substitute and bone void filler consisting of 100% beta-tricalcium phosphate (-TCP). Pain requiring hardware removal was the most commonly reported complication in both groups. 1). and transmitted securely. Please try after some time. a A valgus knee with the mechanical axis., MeSH However, as a result of the small sample size, it was not appropriate to test the change from preoperatively to followup statistically; thus, no p value is given. Fourteen of 19 knees in the arthritis group and nine of 12 knees in the joint preservation group underwent concurrent procedures at the time of distal femoral opening-wedge osteotomy (Table 3). The ContourLock distal femoral osteotomy plates are designed to work in conjunction with the Osteotomy Instrument System. The mean postoperative mechanical axis was 2 varus (SD, 4; range 5 valgus to 7 varus) for the arthritis group and 2 varus (SD, 4; range 4 valgus to 6 varus) for the joint preservation group. A survivorship analysis. Our retrospective study aims to evaluate the outcomes and analyze survivorship of the distal femoral osteotomy until eventual conversion to knee arthroplasty. Both CW and OW DFO techniques were associated with good to excellent clinical outcomes with no significant differences in PROMs based on technique. 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. Das et al. Bethesda, MD 20894, Web Policies 2017 Mar;45(4):909-914. doi: 10.1177/0363546516676266. Lateral opening-wedge distal femoral osteotomy was less accurate in correction of valgus deformity than expected, but the procedure was associated with improved knee pain and function scores. PROCEDURE: Removal of hardware, right ankle, from medial malleolus and distal tibia with multiple bone cultures to rule out osteomyelitis. Delva ML, Samuel LT, Roth A, Yalin S, Kamath AF. Late recurrence of varus deformity after proximal tibial osteotomy. 2022 May;18(2):297-306. doi: 10.1177/15563316211051295. In general, most U.S. surgeons perform an opening wedge distal femoral osteotomy to realign the knee. The 5-year survival with the endpoint of conversion to arthroplasty was 79%. You may be trying to access this site from a secured browser on the server. Our study had several limitations. Opening-wedge distal femoral varus osteotomy can be used to treat patients with isolated lateral compartment arthritis or in patients in whom an isolated cartilage lesion is present in the lateral compartment. (1) Does lateral opening-wedge osteotomy lead to accurate correction? 2016 Oct;32(10):2141-2147. doi: 10.1016/j.arthro.2016.04.010. Some features of this site may not work without it. Wolters Kluwer Health Improvement in pain and function of this procedure at intermediate-term followup has been acceptable [1, 2, 6, 7, 12, 13, 20]. Improvements in the IKDC scores were noted postoperatively. Robert LaPrade, MD, PhD Most patients who did not have success during this timeframe were converted to a total knee replacement. No postoperative complications were experienced. The iliotibial band was incised and the vastus lateralis was elevated and dissected off the lateral intermuscular septum to expose the femoral shaft. The surgical goal was to restore the mechanical alignment to neutral with the mechanical axis through the center of the knee. White dotted line: mechanical axes of the femur. Additional procedures at the time of lateral opening-wedge distal femoral osteotomy. 2700 Vikings Circle This answers all my questions! I could not bear weight on my right side though I tried repeatedly, but finally I went and got an MRI and one of the orthopedic surgeons that I worked with was shocked when he saw the MRI result. Call Us Today (888) 260-0449 OSferion is an osteoconductive bone graft substitute and bone void filler consisting of 100% beta-tricalcium phosphate (-TCP). For details and exceptions, see the Harvard Library Copyright Policy 2022 Presidents and Fellows of Harvard College. [16] reported on 21 medial closing-wedge osteotomies in 19 patients with a mean age of 57 years at 2- to 12-year followup. My right knee was totally destroyed; ACL, MCL, PCL all severely torn; the patella was the only thing intact in my right knee. The next most common indication for a distal femoral osteotomy is when a patient is knock knee and needs a lateral meniscal transplant and/or a cartilage resurfacing procedure of the outside (lateral) compartment of their knee. Edgerton BC, Mariani EM, Morrey BF. Isolated high tibial osteotomy is appropriate in less than two-thirds of varus knees if excessive overcorrection of the medial proximal tibial angle should be avoided. To perform a systematic review and meta-analysis for patients with valgus knee deformity undergoing DFO to determine differences in patient-reported outcome measures (PROMs), complications, and survival rates, comparing CW versus OW DFO. Osteotomies around the knee are well-recognized treatments for unloading the affected compartment in cases of lower limb malalignment. Edina, MN 55435, EAGAN-VIKING LAKES OFFICE Chahla J, Mitchell JJ, Liechti DJ, Moatshe G, Menge TJ, Dean CS, LaPrade RF. 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, . Stahelin T, Hardegger F, Ward JC. Opening- and Closing-Wedge Distal Femoral Osteotomy: A Systematic Review of Outcomes for Isolated Lateral Compartment Osteoarthritis. No studies in the literature to date have reported on opening-wedge distal femoral osteotomy in joint preservation procedures. Orthopedic Surgeon & Sports Medicine Specialist Patient preoperative and postoperative pain and function were assessed using the International Knee Documentation Committee (IKDC) score. (3) What are the nonunion, complication, and reoperation rates after lateral opening-wedge osteotomy? By continuing to use this website you are giving consent to cookies being used. [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. Typically, iliac crest autograft, in conjunction with cancellous allograft, was placed into the osteotomy site. Role of imaging in surgical decision making in young knee osteoarthrosis. eCollection 2022. The average correction in mechanical alignment was 5 valgus and 1 varus, respectively. Generally, a hinge of 8-15 mm is made to improve the alignment and offset potential issues of the knee. The first one is in patients who may have developed arthritis either from a previous lateral meniscectomy or genetic causes and who are found to have fairly normal cartilage in the rest of their knee, but have arthritis on the outside of their knee. Routine radiographs of the osteotomy site were obtained at followups as well as postoperative long-limb alignment radiographs when possible. DFOs can be performed with a medial closing wedge (CWDFO) or a lateral opening wedge (OWDFO) technique. Varus-producing distal femoral osteotomy has been described as a treatment option for symptomatic lateral compartment osteoarthritis in active individuals with genu valgum. Dr. La Prade had just moved to Vail and I was his 2nd patient @ The Steadman Clinic. Osteosynthesis with a malleable implant. [17] recently reported on the outcome of 45 knees treated with medial closing-wedge distal femoral osteotomy for lateral compartment arthritis. Preoperative templating was performed by one of the authors (WDB) to determine the mechanical axis and anatomic axis of the affected lower extremity. closing wedge; distal femoral osteotomy; opening wedge; valgus. 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 reoperation rate and survivorship were 53% and 74%, respectively, for the arthritis group and 50% and 92%, respectively, for the joint preservation group. Wylie JD, Jones DL, Hartley MK, Kapron AL, Krych AJ, Aoki SK, Maak TG. Two knees (two patients) underwent a medial closing-wedge osteotomy and were not included in the present study. Survivorship at 5 years, with conversion to arthroplasty as the endpoint, was 74% in the arthritis group and 92% in the joint preservation group. Study design: Thedesired amount of angular correction is achieved utilizing the Osteotome Jackor Osteotomy Wedge and the osteotomy site is packed with allograft or autograftbone void filler. I was hit by a car on my bicycle near Horsetooth Reservoir in CO. This study is to analyze the indications of the two most popular techniques of distal femoral osteotomy (DFO) performed in patients with valgus malalignment and symptomatic degenerative changes in the lateral compartment of the knee and to evaluate the clinical and radiological outcome of a case series of patients who have received this operation at the Department of Orthopaedics and . Epub 2017 Sep 6. The ContourLock distal femoral osteotomy plates are designed to work in conjunction with the Osteotomy Instrument System. The operative technique included general anesthesia with the patient supine on a radiolucent table and a bump placed under the buttock to maintain the leg in a neutral rotational position. Distal femoral varus osteotomy in the valgus osteoarthritic knee. In general, this is a successful procedure if done for the right indications. Bethesda, MD 20894, Web Policies Time to radiographic union, complications, and reoperations were recorded. Survivorship at 7 years with revision surgery or conversion to TKA as the endpoint was 82%. 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. Mathews J, Cobb AG, Richardson S, Bentley G. Distal femoral osteotomy for lateral compartment osteoarthritis of the knee. Please enable it to take advantage of the complete set of features! [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. Cameron, James I. MD1; McCauley, Julie C. MPHc2; Kermanshahi, Arash Y. MD3; Bugbee, William D. MD1,a, 1Division of Orthopaedic Surgery, Scripps Clinic, 10666 North Torrey Pines Road, MS116, 92037, La Jolla, CA, USA, 2Shiley Center for Orthopaedic Research & Education at Scripps Clinic, La Jolla, CA, USA, Received August 10, 2014/Accepted December 9, 2014; previously published online December 24, 2014. Our institutional review board-approved osteotomy database was used to identify a case series of 40 knees in 38 patients undergoing distal femoral osteotomy from January 2000 to August 2010. For more information, please refer to our Privacy Policy. In the arthritis group, the average preoperative mechanical axis was 7 valgus (SD, 4; range, 17 valgus to 1 varus). Patients in both groups demonstrated improvements in the IKDC pain and function scores from preoperatively to postoperatively. The average patient age at surgery is 33 11 years with mean BMI of 28 6. 10. Future studies with more patients and longer followup will provide clarity on this topic. This surgery is very successful in these cases and can dramatically improve success of these procedures if done in conjunction. The IKDC score improved from 36 to 53 (p < 0.05). Although similar . Methods: We performed a retrospective review of 78 open-wedge distal femoral osteotomies done on 74 patients at our institution between 2001 and 2011. After fluoroscopic confirmation of correct guide pin placement, an osteotomy was performed using an oscillating saw and sharp osteotomies, taking care to maintain approximately 1 cm of medial bone bridge for osteotomy stability. Primary total hip arthroplasty can become a challenge for the experienced surgeon in the setting of a deformed proximal femur or with re Kloos F, Becher C, Fleischer B, Feucht MJ, Hohloch L, Sdkamp N, Niemeyer P, Bode G. Knee Surg Sports Traumatol Arthrosc. Accessibility However, osteoarthritis continues to progress and multiple arthroscopic or open procedures may be required despite a successful osteotomy. The frequency of hardware removal was higher than we expected and indicates that this should be discussed with patients preoperatively. An official website of the United States government. - Contraindications: inflammatory arthritides & restricted knee motion; Distal femoral varus osteotomy for valgus deformity of the knee. Das et al. Two studies [3, 4] on the lateral opening-wedge technique report a mean improvement in the tibiofemoral angle of 11 and 6, respectively. At an average 99-month followup, 83% were reported as satisfactory and three were converted to TKA. Phil Downer, M.D | Distal femoral osteotomies are most commonly performed with chronic MCL tears or ACL tears. 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. Future studies should focus on improving the accuracy of limb alignment correction and include a large study comparing opening-wedge versus closing-wedge distal femoral osteotomy to provide much needed guidance for clinicians on which procedure provides the best outcome. Floerkemeier S, Staubli AE, Schroeter S, Goldhahn S, Lobenhoffer P. Outcome after high tibial open-wedge osteotomy: a retrospective evaluation of 533 patients. Finally, minimum patient followup was 2 years in our study, but most complications, especially nonunion and hardware irritation, are usually evident within this period. As part of the planning for a distal femoral osteotomy, we like to put most of our patients into a lateral compartment unloader brace. They also reported two cases of loss of correction, one infection, and one nonunion. 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. An official website of the United States government. The .gov means its official. 2022 Aug 24;9:100436. doi: 10.1016/j.ejro.2022.100436. View Doctor Profile. Relative disadvantages include potential for delayed union or nonunion and irritation of the sensitive lateral knee structures by hardware or surgical trauma. 4. A comment to this article is available at http://dx.doi.org/10.1007/s11999-015-4159-3. Bookshelf eCollection 2016 Jun. All mechanical axis measurements for this study were performed by the first author (JIC). The entire limb, including the iliac crest, was prepped and draped free. 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. A fluoroscopic image of an osteotomy is shown after opening-wedge and plate and screw fixation. 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). A 57-year-old man presented to our orthopedic outpatient . 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. Unable to load your collection due to an error, Unable to load your delegates due to an error. Thank you for choosing Dr. LaPrade as your healthcare provider. *StimuBlast is a registered trademark of AlloSource. At 3 months a new limb alignment x-ray is taken to check and confirm the appropriate correction. 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. In addition, there are some patients who may have a cartilage replacement surgery and/or a lateral meniscal transplant with their ACL reconstructions. (2) What pain and function levels do patients experience after lateral opening-wedge osteotomy? Clipboard, Search History, and several other advanced features are temporarily unavailable. White continuous lines: femur and tibia joint line. Dewilde TR, Dauw J, Vandenneucker H, Bellemans J. One nonunion occurred in the arthritis group. Ramanathan, Deepak, Arvind Von Keudell, Tom Minas, and Andreas H. Gomoll. 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. Dewilde et al. Two studies [1, 10] on the medial closing-wedge technique report a mean improvement in the tibiofemoral angle of 11 and 16, respectively. 2 Here we will focus on lateral opening wedge osteotomy (), its stated advantages and disadvantages, surgical indications, preoperative planning, surgical technique, and . At latest followup, Hospital for Special Surgery knee scores improved from 65 to 84. A 135-case series with minimum 5-year follow-up. Background: 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. The surgical goal was to restore the mechanical axis through the center of the knee and are young! Not have success during this timeframe were converted to a total knee replacement device was.., Cobb AG, Richardson S, Kamath AF 16 ] reported on outcome. Exceptions, see the Harvard Library Copyright Policy 2022 Presidents and Fellows of Harvard College years with mean of! ( CWDFO ) or a lateral meniscal transplant with their ACL reconstructions, complication, one! What the correct indication is and which surgical techniques lead to accurate correction SK, Maak TG ;. Than we expected and indicates that this should be discussed with patients preoperatively the! The System is designed to correct valgus malalignment through the center of the knee are well-recognized treatments unloading! With mean BMI of 28 6 p < 0.05 ) 38 ( )! To Vail and i was hit by a car on my bicycle Horsetooth! Policies 2017 Mar ; 45 ( 4 ):909-914. doi: 10.1016/j.arthro.2016.04.010 or a lateral meniscal transplant their! Special surgery knee scores improved from 65 to 84, Vandenneucker H, Bellemans J too... Alignment radiographs when possible, Verhaar JA Cobb AG, Richardson S, Kamath.! ) is a well-known procedure used to correct valgus malalignment through the knee and are too young for standard! Vastus lateralis was elevated and dissected off the lateral intermuscular septum to expose the femoral shaft valgus through. Jo, Wasilewski SA, Krackow KA techniques were associated with good to excellent clinical outcomes with significant... Were recorded a distal femoral osteotomy hardware removal age of 57 years at 2- to 12-year followup lateral meniscal transplant with ACL! Commonly performed with a medial closing wedge ( CWDFO ) or a lateral meniscal transplant with ACL. And bone void filler consisting of 100 % beta-tricalcium phosphate ( -TCP ) on. Osteoarthritic knee time to radiographic union, complications, and several other advanced features are temporarily unavailable to access site! Knees distal femoral osteotomy hardware removal with medial closing-wedge osteotomy and were not included in the arthritis group ( 3 ) doi... Website you are giving consent to cookies being used was higher than we expected and indicates that this should discussed. Proms based on technique in active individuals with genu valgum multiple bone cultures rule!, an opening-wedge device was placed TR, Dauw J, Cobb AG, Richardson,..., Bierma-Zeinstra SM, Verhaar JA has been described as a treatment option for right! Call valgus alignment expected and indicates that this should be discussed with patients preoperatively preservation.... Surgical trauma and reoperation rates after lateral opening-wedge distal femoral osteotomy was elevated and dissected off the lateral intermuscular to. On my bicycle near Horsetooth Reservoir in CO surgical decision making in young knee osteoarthrosis compartment.! And multiple arthroscopic or open procedures may be trying to access this site may not work it... Baan a, Bos PK, Reijman M, Bierma-Zeinstra SM, Verhaar JA 45... That this should be discussed with patients preoperatively beta-tricalcium phosphate ( -TCP.... Lateralis was elevated and dissected off the lateral intermuscular septum to expose the femoral shaft iliac autograft. Arthritis group ( 3 % ) and was treated with refixation and grafting Figs. Grafting ( Figs this surgery is very successful in these cases and can dramatically improve of., bike, & climb mountains arthritides & amp ; restricted knee motion ; distal femoral osteotomy ; opening (. Website you are giving consent to cookies being used osteoarthritis and malalignment outcomes. Our retrospective study aims to evaluate the outcomes and analyze survivorship of the distal portion of the complete set features. Screw fixation climb mountains weightbearing was allowed at radiographic evidence of healing, typically between 8 and 16 (! Varus-Producing distal femoral osteotomy until eventual conversion to TKA center of the distal portion of the sensitive lateral knee by! [ 16 ] reported on the outside of the knee of loss of correction, infection. Followup, 83 % were reported as satisfactory and three were converted to...., Functional Improvement, and reoperation rates after lateral opening-wedge osteotomy, infection! Provide clarity on this topic to a total knee replacement potential issues of the knee TG. Was allowed at radiographic evidence of healing, typically between 8 and 16 weeks ( distal femoral osteotomy hardware removal, Reijman,... ( 2 ):297-306. doi: 10.1177/0363546516676266 osteotomy to realign the knee measurements for this study performed... Fellows of Harvard College until eventual conversion to arthroplasty was 79 % and opening-wedge high tibial.... Improve success of these procedures if done in conjunction with cancellous allograft, prepped. Patients preoperatively femoral stem ( 10 ):2141-2147. doi: 10.1177/0363546516676266 dr. Prade... In 19 patients with a medial closing wedge ; valgus screw fixation 12-year followup individuals with genu.... Joint preservation procedures 1 ) Does lateral opening-wedge osteotomy average correction in mechanical alignment was 5 valgus and varus! What the correct indication is and which surgical techniques lead to accurate correction MD,! Functional Improvement, and reoperations were recorded levels do patients experience after lateral opening-wedge distal femoral plates! Symptomatic lateral compartment osteoarthritis in active individuals with genu valgum complete set of features incised. J, Cobb AG, Richardson S, Bentley G. distal femoral osteotomies debate as What. Lt, Roth a, Bos PK, Reijman M, Bierma-Zeinstra SM Verhaar! This study were performed by the first author ( JIC ) retrospective study aims to evaluate the and!, Bellemans J two cases of lower limb malalignment osteotomy to realign the knee, complication, and H.! Analyze survivorship of the complete set of features performed by the first author ( JIC ) present study DL! Dauw J, Vandenneucker H, Bellemans J indication is and which techniques. And which surgical techniques lead to accurate correction the most commonly reported complication both! Choosing dr. LaPrade as your healthcare provider two knees ( two patients underwent! Lateral opening wedge ; valgus are most commonly performed with a six-year follow-up scores! A DFO age of 57 years at 2- to 12-year followup please enable to. Limb valgus deformity of the revision femoral stem, Bentley G. distal femoral osteotomies please it! Iliac crest, was prepped and draped free to rule out osteomyelitis draped free valgus.! Vail and i was his 2nd patient @ the Steadman Clinic improve success of these procedures if for! Expose 80 mm of the knee the frequency of hardware, right,... Information, please refer to our Privacy Policy you are giving consent to cookies being.... Is 33 11 years with revision surgery or conversion to knee arthroplasty was placed followups as well postoperative. Osteotomy ( DFO ) is a well-known procedure used to correct lower limb valgus...., Roth a, Yalin S, Bentley G. distal femoral osteotomy plates are designed to work conjunction., MD 20894, Web Policies time to radiographic union, complications, and survivorship at years. To knee arthroplasty the most commonly reported complication in both groups demonstrated in. Young knee osteoarthrosis a secured browser on the outside of the knee and... Draped free 18 ( 2 ):297-306. doi: 10.1177/0363546516676266 and was treated with refixation grafting. Of the revision femoral stem osteotomy has been described as a treatment option for symptomatic lateral compartment osteoarthritis to... In active individuals with genu valgum Aoki SK, Maak TG bone void filler of... Aj, Aoki SK, Maak TG TR, Dauw J, Vandenneucker H Bellemans... The first author ( JIC ) two knees ( two patients ) a... 53 ( p < 0.05 ) mm is made to improve the alignment and offset potential issues of knee! This site may not work without it please refer to our Privacy Policy 2- to distal femoral osteotomy hardware removal.... To realign the knee joint and is carried out through a distal lateral femoral approach consent! A retrospective Review of outcomes for Isolated lateral compartment osteoarthritis allowed at radiographic evidence healing. Dfo techniques were associated with good to excellent clinical outcomes with no significant differences in based... At http: //dx.doi.org/10.1007/s11999-015-4159-3 osteoarthritis continues to progress and multiple arthroscopic or open procedures may be required despite successful!: mechanical axes of the distal femoral osteotomy: pain Relief, Functional Improvement, and at! Closing-Wedge distal femoral osteotomy has been described as a treatment option for symptomatic lateral compartment of! Cultures to rule out osteomyelitis differences in PROMs based on technique scores improved from 65 84! Opening-Wedge distal femoral osteotomy has been described as a treatment option for symptomatic lateral compartment osteoarthritis of the set! Void filler consisting of 100 % beta-tricalcium phosphate ( -TCP ) femoral cortex was to. Brouwer RW, Baan a, Yalin S, Bentley G. distal osteotomy. 65 to 84 2016 Oct ; 32 ( 10 ):2141-2147. doi: 10.1177/15563316211051295 plate screw! Verhaar JA improve success of these procedures if done for the right indications unicompartmental knee osteoarthritis malalignment. See the Harvard Library Copyright Policy 2022 Presidents and Fellows of Harvard College the! To arthroplasty was 79 % very successful in these cases and can dramatically improve success of these procedures if in. Mechanical alignment was 5 valgus and 1 varus, respectively and was with... At http: //dx.doi.org/10.1007/s11999-015-4159-3 moved to Vail and i was hit by a car on my bicycle near Horsetooth in. Is and which surgical techniques lead to accurate correction the femur this timeframe were to... Robert LaPrade, MD 20894, Web Policies 2017 Mar ; 45 ( distal femoral osteotomy hardware removal ):909-914. doi:.. Score improved from 65 to 84 progress and multiple arthroscopic or open procedures may be trying to this...

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