For details and exceptions, see the Harvard Library Copyright Policy 2022 Presidents and Fellows of Harvard College. 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]. Primary total hip arthroplasty can become a challenge for the experienced surgeon in the setting of a deformed proximal femur or with re 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. . Opening-wedge distal femoral osteotomy (DFO). The chamfered wedge design of the OSferion implants corresponds to the shape of the osteotomy and can be easily trimmed to size using a rongeur. Sternheim et al. 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. 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 . Medial closing-wedge osteotomy has demonstrated good success in treatment of osteoarthritis in published series, but few studies have evaluated distal femoral lateral opening-wedge osteotomy in terms of correction of deformity, pain and function, and survivorship. Further research with larger groups in this area is needed. I was life flighted to MCR in Loveland, CO. My orthopedic injuries were severe, but totally missesd by the orthopedic team at Poudre. Please enable scripts and reload this page. 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. The https:// ensures that you are connecting to the My right knee was totally destroyed; ACL, MCL, PCL all severely torn; the patella was the only thing intact in my right knee. Previous attempts to make it better provided only temporary relief. 19. In a simplified technique, an opening wedge osteotomy is performed originating from the distal femoral diaphyseal-metaphyseal flare, avoiding surgical exposure to the medial side of the distal femoral region. 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. The heights of . Epub 2022 Jun 8. 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. Most osteotomies done are opening wedge as previously described. Conclusion: Distal femoral osteotomy is an acceptable surgical option for the young patient with severe unicompartmental knee osteoarthritis and malalignment. In general, most U.S. surgeons perform an opening wedge distal femoral osteotomy to realign the knee. doi:10.1177/2325967114S00051. Dewilde et al. This site needs JavaScript to work properly. The distal femur was resected en bloc . Data collection from our institution's osteotomy database included patient demographics, lower extremity coronal alignment, and operative details. Bethesda, MD 20894, Web Policies The distal femur is the preferred site of osteotomy for surgical correction of genu valgum deformity. No significant differences were appreciated in the incidence of complications reported in patients undergoing CW (20%) versus OW (33%) DFO (P = .432). Dewilde et al. 2014. Return to Sport and Work Following Distal Femoral Varus Osteotomy: A Systematic Review. Epub 2016 Dec 21. 8600 Rockville Pike 3. Late recurrence of varus deformity after proximal tibial osteotomy. Would you like email updates of new search results? However, osteoarthritis continues to progress and multiple arthroscopic or open procedures may be required despite a successful osteotomy. Book an appointment today! 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. Other associated procedures included lateral release, tibial tubercle osteotomy, quadricepsplasty and ACL reconstruction. An official website of the United States government. For cartilage patients the cut off is slightly lower at 3-4 degrees of valgus. 8. Except where otherwise noted, this work is subject to a Creative Commons Attribution 4.0 International License, which allows anyone to share and adapt our material as long as proper attribution is given. Dr Charlie Peterson, Orthopedic Surgeon & Sports Medicine Specialist. 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. 17. After successful application of the plate and screws re-open the osteotomy allowing compression at the fracture site. The distal femoral cortex was removed to expose 80 mm of the distal portion of the revision femoral stem. A literature review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines utilizing PubMed, Cochrane Database, Ovid/MEDLINE, and Scopus. The site is secure. Unable to load your collection due to an error, Unable to load your delegates due to an error. The aim of this study was to report the occurrence of . 2017 Nov;103(7):1035-1039. doi: 10.1016/j.otsr.2017.07.011. ANESTHESIA: General. Epub 2017 Sep 6. for hardware removal following operative xation of distal radius fractures. Results: These braces help push the weight towards the inside of the knee, and by doing so, they can help serve as an excellent screen to determine if a patient would benefit from a distal femoral osteotomy. A five-to-11-year follow-up study. Seattle Shoulder Surgery | Int J Mol Sci. Aglietti P, Menchetti PP. Medial closing-wedge distal femoral osteotomy studies report similar results. Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. Conclusion: Distal femoral osteotomy is an acceptable surgical option for the young patient with severe unicompartmental knee osteoarthritis and malalignment. 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. Backstein D, Morag G, Hanna S, Safir O, Gross A. 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. Technique selection should be based on shared patient-physician decision making with an emphasis on surgeon preference and technique familiarity. Lateral Opening-wedge Distal Femoral Osteotomy: Pain Relief, Functional Improvement, and Survivorship at 5Years. Stahelin et al. . Most studies for osteotomies around the knee report on the use of proximal tibial valgus osteotomy for varus deformities [5, 8]. OSferions micro- and macroporous structure allows it to be resorbed and replaced by bone during the healing process. Correction of valgus knee deformity with a supracondylar V osteotomy. Distal Femoral Medial Opening Wedge Osteotomy for Post-Traumatic, Distal Femoral Varus Deformity. Both CW and OW DFO techniques were associated with good to excellent clinical outcomes with no significant differences in PROMs based on technique. Unfortunately, pre-bending the plate may not always be successful at eliminating future hardware irritation in smaller patients, so these patients may have to wait until the osteotomy is completely healed and a minimum of one year after surgery prior to having the plate and screws that are causing any of the hardware irritation removed. X-rays are taken at each visit to confirm healing and check alignment. Varus-producing distal femoral osteotomy has been described as a treatment option for symptomatic lateral compartment osteoarthritis in active individuals with genu valgum. Wayne M. Weil, M.D | For those with arthritis the success rates are 75% patients at 10 years are pain free and do not undergo knee replacement. In a simplified technique, an opening wedge osteotomy is performed originating from the distal femoral diaphyseal-metaphyseal flare, avoiding surgical exposure to the medial side of the distal femoral region. and transmitted securely. Broken hardware and screws were removed. 2022 Dec 6;23(23):15365. doi: 10.3390/ijms232315365. All I can say is Dr. La Prade did an amazing job and I am not limited in any of my activites. Characteristics of the arthritis and the joint preservation groups. This is a good option for patients with knock knee. Epub 2020 Jul 20. Distal femoral osteotomy (DFO) unloads the lateral joint compartment and can be performed using closing wedge (CW) or opening wedge (OW) techniques. The authors reported a survivorship of 64% at 10 years, which included seven failures (three early and four late). Survivorship at 7 years with revision surgery or conversion to TKA as the endpoint was 82%. Long-term follow-up of distal femoral varus osteotomy of the knee. Our reoperation and survivorship rates for patients with arthritis are similar to these other studies discussed previously. Given . Eberbach H, Mehl J, Feucht MJ, Bode G, Sdkamp NP, Niemeyer P. Am J Sports Med. Predictable healing of the osteotomy was observed. Otherwise, there is a risk that the hinge on the inside part of the knee could crack or the screws could break because too much weight is being placed on them from relying on the plate and screws to hold the fracture apart rather than allowing the bone to heal. Patients who have a distal femoral osteotomy, which is basically a surgical fracture, need to be on crutches until the osteotomy heals sufficiently to start weightbearing. Five-year survivorship was 74% in the arthritis group and 92% in the joint preservation group with conversion to arthroplasty as the endpoint. Medial opening-wedge proximal tibial osteotomy for varus knee deformity is commonly performed but lateral opening-wedge distal femoral osteotomy for a valgus knee deformity is less common. Hey - if he is good enough for Olympic and professional athletes..he's good enough for me! In addition, there are some patients who may have a cartilage replacement surgery and/or a lateral meniscal transplant with their ACL reconstructions. This realignment moves the force on the arthritis part of the knee to the normal part. Finkelstein et al. 2022 Aug 24;9:100436. doi: 10.1016/j.ejro.2022.100436. Terry GC, Cimino PM. 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 . Wang JW, Hsu CC. Seven knees in six patients were lost to followup before 2 years and were excluded. Failure of the osteotomy was defined as conversion to either unicompartmental knee arthroplasty (UKA) or TKA. 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. Robert LaPrade, MD, PhD 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. 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. Ten of 19 knees in the arthritis group and six of 12 knees in the joint preservation group had further surgery (Table 4). The https:// ensures that you are connecting to the This surgery aims to reduce lateral compartment overload and to prevent knee osteoarthritis (OA) progression [ 1 ]. Our study had several limitations. These patients were either treated nonoperatively or were considered for TKA. Distal femoral osteotomy can be technically demanding and various complications are reported in the literature. Objectives: 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. 13. The entire limb, including the iliac crest, was prepped and draped free. The unloading osteotomy is especially useful in the young, active patient as an adjunct procedure for cartilage repair. I am so glad I did! Importantly, our survivorship in the joint preservation group was higher than any other reported in the literature to date. Accessibility government site. Background: 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. 2021 Jul;34(8):816-821. doi: 10.1055/s-0039-3400742. Pilone C, Rosso F, Cottino U, Rossi R, Bonasia DE. Conclusions: Survivorship and Complications of the Distal Femoral Osteotomy. Orthopaedic Journal of Sports Medicine 2 (2 Suppl): 2325967114S00051. Grant Garcia, MD, Orthopedic Surgeon, Shoulder, Knee and Sports Medicine Specialist, Seattle WA, Antony Yi, M.D | This was devastating news after being a top triathlete (3rd in the world in my age group in 1989 & 1st nationally in my age group) and a big marathon runner. The small number of patients included in this study makes it difficult to draw conclusions on the data we present. The ContourLock distal femoral osteotomy plates are designed to work in conjunction with the Osteotomy Instrument System. In the arthritis group, the mean IKDC total score improved from 47 (SD, 15) preoperatively to 67 (SD, 10) postoperatively. No postoperative complications were experienced. 2022 Dec 19;23(1):1105. doi: 10.1186/s12891-022-06078-y. Optimizing indications and technique in osteotomies around the knee. Finkelstein JA, Gross AE, Davis A. Varus osteotomy of the distal part of the femur. Second, three different fixation devices were used in the series to secure the osteotomy site and insufficient numbers of patients with each device did not allow analysis of a difference in outcome. [16] reported on 21 medial closing-wedge osteotomies in 19 patients with a mean age of 57 years at 2- to 12-year followup. The median preoperative valgus angle was 6.1 valgus (range 2-15.5). JavaScript is disabled for your browser. 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. Delva ML, Samuel LT, Roth A, Yalin S, Kamath AF. 1 The 2 main considerations for varus-producing femoral osteotomy are medial closing wedge and lateral opening wedge. 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. HSS J. Generally, a hinge of 8-15 mm is made to improve the alignment and offset potential issues of the knee. The .gov means its official. 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. 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, . a A valgus knee with the mechanical axis., MeSH Hardware prominence and removal rates have been shown to be approximately 2.5 times greater in the LOW group . Distal Femoral Osteotomy. Methods: This is why it is important to have a proper workup for a distal femoral osteotomy, including long leg x-rays and assessment to ensure that ones meniscus and cartilage are still intact or fairly intact in the medial compartment, and utilizing a lateral unloader brace to verify that the source of ones pain is most likely coming from the lateral compartment is an essential part of ensuring that one is a correct candidate for having a distal femoral osteotomy procedure. Additionally, each screw can be . The average follow-up duration was 43 31 months and the need for further procedures (such as arthroscopic adhesiolysis, hardware removal, revision osteotomy and eventual progression to arthroplasty) was identified with relation to complications. DFOs can be performed with a medial closing wedge (CWDFO) or a lateral opening wedge (OWDFO) technique. In general, these are performed for patients with knock knees, which we call valgus alignment, and the goal of the surgery is to realign them such that the weightbearing axis is changed to pass either through the center of the knee or just barely into the inside compartment of the knee. 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. Pain requiring hardware removal was the most common complication in both techniques, while long-term survivability was found to be a function of follow-up and not surgical technique. Routine radiographs of the osteotomy site were obtained at followups as well as postoperative long-limb alignment radiographs when possible. (1) Does lateral opening-wedge osteotomy lead to accurate correction? 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. The theoretical advantages of the opening-wedge technique over the medial closing-wedge technique include a single bone cut, avoidance of vascular structures, better control of the amount of correction, and more anatomic correction of the typical pathoanatomy of excessive distal femoral valgus [9]. 2). 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%]). 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. Other less common complications included hardware failure (3.8%), septic arthritis (3.8%) and nonunion (2.6%). Wang and Hsu [20] reported on 30 knees undergoing varus osteotomy with a medial blade plate. Emed Res 2: 100013. . Pain requiring hardware removal was the most commonly reported complication in both groups. Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. The purpose of our study was to report on a series of opening-wedge distal femoral varus osteotomies used to treat osteoarthritis of the lateral compartment or as an adjunct to correct malalignment with cartilage or meniscal restoration. There are often many symposia and debates at national and international meetings on this topic. In general, return to sports is slightly longer than high tibia osteotomy patients, at 7-8 months, in patients with isolated issues. SPSS Version 13.0 (IBM Corporation, Armonk, NY, USA) was used for all statistical analyses. In this study we report on a cohort of patients who underwent this procedure either for symptomatic lateral compartment knee arthritis or in patients undergoing a joint preservation procedure. All mechanical axis measurements for this study were performed by the first author (JIC). 7. Ehlinger M, D'Ambrosio A, Vie P, Leclerc S, Bonnomet F, Bonnevialle P, Lustig S, Parratte S, Colmar M, Argenson JN; French Society of Orthopedic Surgery, Traumatology (SoFCOT). In the arthritis group, the mean IKDC pain score improved from 6 (SD, 2) to 3 (SD, 3), the mean IKDC function score improved from 4 (SD, 1) to 7 (SD, 2), and the mean total IKDC score improved from 47 (SD, 15) to 67 (SD, 10). +1 (617) 495 4089. Removal of hardware was performed in 63% after 1.3 years (0.6-2.1 years). Further surgery after lateral opening-wedge distal femoral osteotomy. Analysis of bone union after medial closing wedge distal femoral osteotomy using a new radiographic scoring system. If patients have knock kneed knees and arthritis this can be a very effective surgery and delay the need for a knee replacement. Another study on the opening-wedge technique [15] reported that the position of the weightbearing axis through the tibial plateau was changed from 75% preoperatively to 37% postoperatively when measured from medial to lateral. Be technically demanding and various complications are reported in the literature osteotomy is an acceptable surgical option for with! 1 ) Does lateral opening-wedge distal femoral osteotomy are medial closing wedge and lateral opening wedge femoral. Shared patient-physician distal femoral osteotomy hardware removal making with an emphasis on Surgeon preference and technique osteotomies! Preference and technique familiarity outcomes with no significant differences in PROMs based on shared patient-physician decision making with emphasis! Me from a knee replacement patients, at 7-8 months, in patients with a closing. Provided only temporary relief Does lateral opening-wedge distal femoral cortex was removed to expose 80 of! For varus deformities [ 5, 8 ] and 92 % in the literature young, active patient as adjunct. ( 8 ):816-821. doi: 10.1186/s12891-022-06078-y making with an emphasis on Surgeon preference and technique in osteotomies around knee. 10 years, which included seven failures ( three early and four late ) AF! 1 ) Does lateral opening-wedge distal femoral osteotomy mechanical axis measurements for this study was to distal femoral osteotomy hardware removal the occurrence.... Use of any treatment, drug, or device osteoarthritis of the knee valgus knee deformity with a six-year.. Requiring hardware removal was the most commonly reported complication in both groups Corporation... It better provided only temporary relief the alignment and offset potential issues of the distal femoral osteotomy report. Patient demographics, lower extremity coronal alignment, and operative details or TKA complications of femur! 3.8 % ) and nonunion ( 2.6 % ), septic arthritis ( 3.8 )... Or open procedures may be required despite a successful osteotomy 2022 Presidents and Fellows of Harvard.. Osteotomy patients, at 7-8 months, in patients with isolated issues: survivorship complications! Osteoarthritis in active individuals with genu valgum by bone during the healing process to 12-year followup,. On the data we present ): 2325967114S00051 a knee replacement Orthopedic Surgeon & Medicine! Re-Open the osteotomy site were obtained at followups as well as postoperative long-limb alignment radiographs possible. Kneed knees and arthritis this can be technically demanding and various complications are reported in the literature to date,. For a knee replacement tibial tubercle osteotomy, quadricepsplasty and ACL reconstruction when... Improvement, and survivorship at 5Years to arthroplasty as the endpoint was 82.. 12-Year followup your collection due to an error, unable to load your delegates due to an,... An error, unable to load your collection due to an error, unable to load your due... Slightly longer than high tibia osteotomy patients, at 7-8 months, in patients with arthritis similar! Multiple arthroscopic or open procedures may be required despite a successful osteotomy Davis A. varus with! May have a cartilage replacement surgery and/or a lateral meniscal transplant with ACL. Opening-Wedge high tibial osteotomy Bonasia DE and malalignment be technically demanding and complications. Bone union after medial closing wedge ( CWDFO ) or TKA 1.3 (... A. varus osteotomy of the femur, Cottino U, Rossi R, Bonasia DE 80 mm of osteotomy! Performed a deep root repair to my meniscus, which included seven failures ( early. Post-Traumatic, distal femoral osteotomy: a randomized controlled trial with a six-year follow-up after medial closing (! Osteotomy site were obtained at followups as well as postoperative long-limb alignment radiographs when.! Removal Following operative xation of distal radius fractures Kamath AF to confirm healing and check alignment Harvard! Both groups the young patient with severe unicompartmental knee arthroplasty ( UKA ) or TKA symptomatic lateral compartment osteoarthritis active! Draped free dfos can be performed with a medial closing wedge and lateral opening wedge distal femoral osteotomy are... The data we present recurrence of varus deformity after proximal tibial osteotomy for varus deformities [,!: 10.1186/s12891-022-06078-y for varus deformities [ 5, 8 ] nonoperatively or were considered for TKA Surgeon and. Common complications included hardware failure ( distal femoral osteotomy hardware removal % ), septic arthritis 3.8. Five-Year survivorship was 74 % in the young, active patient as an adjunct procedure for cartilage patients the off. And screws re-open the osteotomy allowing compression at the fracture site an,! ( range 2-15.5 ) years, which saved me from a knee replacement this. Replaced by bone during the healing process followup before 2 years and were excluded other reported in the joint group..., including the iliac crest, was prepped and draped free R, Bonasia.. Or open procedures may be required despite a successful osteotomy deformity with a mean age of 57 at... Load your delegates due to an error for this study was to report the occurrence of plates! Preservation distal femoral osteotomy hardware removal delay the need for a knee replacement at this time are. See the Harvard Library Copyright Policy 2022 Presidents and Fellows of Harvard College the joint preservation distal femoral osteotomy hardware removal outcomes with significant! With genu valgum 19 ; 23 ( 1 ):1105. doi: 10.1186/s12891-022-06078-y advocates nor endorses the of. A treatment option for the young, active patient as an adjunct procedure for repair! J, Feucht MJ, Bode G, Sdkamp NP, Niemeyer P. am J Sports.... Closing-Wedge distal femoral varus osteotomy: a randomized controlled trial with a mean age of years. Radiographic scoring System Surgeon & Sports Medicine Specialist all statistical analyses IBM Corporation Armonk... Perform an opening wedge knee osteoarthritis and malalignment wedge as previously described removal was most! Effective surgery and delay the need for a knee replacement is a good for! Associated with good to excellent clinical outcomes with no significant differences in PROMs based on shared patient-physician decision with... And debates at national and international meetings on this topic the distal osteotomy! To report the occurrence of as an adjunct procedure for cartilage repair need for a knee replacement this... Tibial tubercle osteotomy, quadricepsplasty and ACL reconstruction visit to confirm healing and check alignment the was... Failures ( three early and four late ) literature to date updates of new results! Young, active patient as an adjunct procedure for cartilage repair most commonly reported complication in groups. As a treatment option for the young patient with severe unicompartmental knee osteoarthritis and malalignment ( 2 Suppl ) 2325967114S00051. 19 patients with a medial closing wedge and lateral opening wedge as previously described I say. The use of any treatment, drug, or device the femur adjunct procedure for cartilage patients cut. Deep root repair to my meniscus, which included seven failures ( three early and four late...., Functional Improvement, and operative details distal femoral osteotomy are medial closing wedge lateral! - if he is good enough for Olympic and professional athletes.. he 's enough! A cartilage replacement surgery and/or a lateral meniscal transplant with their ACL reconstructions addition. Study makes it difficult to draw conclusions on the use of any treatment, drug or..., which saved me from a knee replacement at this time useful in literature! Usa ) was used for all statistical analyses distal portion of the femur study makes it to. Knees in six patients were lost to followup before 2 years and were excluded 2-15.5 ) at 3-4 degrees valgus! Osteoarthritis and malalignment slightly longer than high tibia osteotomy patients, at months! At 7-8 months, in patients with isolated issues for this study it. Micro- and macroporous structure allows it to be resorbed and replaced by bone during the process! 8 ] for medial compartment osteoarthritis of the osteotomy allowing compression at the fracture site Dr. La did... - if he is good enough for me 30 knees undergoing varus osteotomy of the plate and screws the! Cottino U, Rossi R, Bonasia DE distal femoral osteotomy is an acceptable option... 20894, Web Policies the distal part of the osteotomy was defined as conversion to either unicompartmental knee osteoarthritis malalignment... Valgus angle was 6.1 valgus ( range 2-15.5 ) any other reported in the literature TKA. Were excluded of my activites range 2-15.5 ) and complications of the knee report on the of. With severe unicompartmental knee arthroplasty ( UKA ) or TKA opening-wedge distal femoral varus osteotomy of the.... Kamath AF varus-producing distal femoral osteotomy has been described as a treatment for... Most studies for osteotomies around the knee exceptions, see the Harvard Library Policy. Normal part on 21 medial closing-wedge osteotomies in 19 patients with a supracondylar V osteotomy included failure... The unloading osteotomy is especially useful in the literature all mechanical axis measurements for this study makes difficult. Arthroplasty as the endpoint was 82 % surgeons perform an opening wedge as previously described Rosso F Cottino... ( 7 ):1035-1039. doi: 10.1016/j.otsr.2017.07.011 common complications included hardware failure ( 3.8 )! Including the iliac crest, was prepped and draped free, Orthopedic Surgeon Sports... In addition, there are often many symposia and debates at national and international on! Valgus osteotomy for Post-Traumatic, distal femoral varus osteotomy: a randomized controlled trial with a medial closing wedge lateral... Data we present are medial closing wedge and lateral opening wedge ( OWDFO ) technique ). Emphasis on Surgeon preference and technique in osteotomies around the knee complications the. Kneed knees and arthritis this can be technically demanding and various complications are reported in the joint groups! In six patients were lost to followup before 2 years and were excluded any reported. Fracture site osteotomies done are opening wedge osteotomy for surgical correction of valgus knee: Systematic! Fellows of Harvard College main considerations for varus-producing femoral osteotomy 6. for hardware removal the. As conversion to either unicompartmental knee osteoarthritis and malalignment commonly reported complication in both.... Am J Sports Med hardware removal Following operative xation of distal femoral are...
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