Generally, a hinge of 8-15 mm is made to improve the alignment and offset potential issues of the knee. official website and that any information you provide is encrypted 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. 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. 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. The third most common reason for a distal femoral osteotomy is in patients who have a chronic MCL tear who are in valgus alignment. Cameron JI, McCauley JC, Kermanshahi AY, Bugbee WD. 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 . Results: Of the 71 patients who followed -up beyond six months post-operatively, seven eventually converted to total knee arthroplasty (9.9%). 16. 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. 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. HSS J. Distal femoral osteotomy for valgus deformity of the knee. Most studies for osteotomies around the knee report on the use of proximal tibial valgus osteotomy for varus deformities [5, 8]. This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at, Creative Commons Attribution 4.0 International License, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4597517/pdf/, http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAA, http://nrs.harvard.edu/urn-3:HUL.InstRepos:23845128. doi:10.1177/2325967114S00051. View Doctor Profile. Call Us Today (888) 260-0449 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. 10. - Contraindications: inflammatory arthritides & restricted knee motion; Distal femoral varus osteotomy for valgus deformity of the knee. Hey - if he is good enough for Olympic and professional athletes..he's good enough for me! 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. This video shows the surgical technique for a medial opening wedge distal femoral osteotomy, for correcting a knee with valgus deformity (courtesy of Arthrex). 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. +1 (617) 495 4089. This answers all my questions! Hardware removal, yes (%) 65 (66) 37 (59) 28 (80) Timing of hardware removal, years (SD) 1.0 (0. . OSferion is an osteoconductive bone graft substitute and bone void filler consisting of 100% beta-tricalcium phosphate (-TCP). Distal femoral osteotomy (DFO) is a well-accepted procedure for the treatment of femoral deformities and associated symptoms including osteoarthritis, especially in younger and physically active patients in whom knee arthroplasty is undesirable. COMPLICATIONS: None. A survivorship analysis. 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. While this is very uncommon, putting weight on it before Dr. Garcia instructs you, high BMI or smoking can increase this risk. 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. 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. PMC In the joint preservation group, the mean IKDC pain score improved from 6 (SD, 1) to 2 (SD, 2), the mean IKDC function score improved from 3 (SD, 3) to 6 (SD, 2), and the mean total IKDC score improved from 36 (SD, 12) to 62 (SD, 18). Aglietti P, Menchetti PP. Routine closure was then performed and the patient was placed into a ROM brace. . 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. Survivorship at 5 years, with conversion to arthroplasty as the endpoint, was 74% in the arthritis group and 92% in the joint preservation group. 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. 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. 7. 8. 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. Emed Res 2: 100013. . 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). 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). Distal femoral varus osteotomy may be used to treat valgus knee malalignment or to protect a knee compartment in which cartilage restoration surgery (such as osteochondral or meniscus allografting) has been performed. [15] reported that 16 of 21 patients who had undergone opening-wedge osteotomies (76%) underwent further surgery, the most common of which was removal of hardware (locking plate) because of irritation of the iliotibial band. Patients who had any symptoms in the medial or patellofemoral compartment in addition to the lateral compartment were not considered for osteotomy. Osteotomies around the knee are well-recognized treatments for unloading the affected compartment in cases of lower limb malalignment. lateral, distal femoral osteotomy. Would you like email updates of new search results? Previous attempts to make it better provided only temporary relief. Saithna A, Kundra R, Getgood A, Spalding T. Opening wedge distal femoral varus osteotomy for lateral compartment osteoarthritis in the valgus knee. 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. 2021 Jul;34(8):816-821. doi: 10.1055/s-0039-3400742. Under fluoroscopic control, the starting point for the osteotomy was located approximately 3 cm above the lateral femoral epicondyle and a guide pin was angled medially and distally toward the base of the metaphyseal flare of the medial femoral condyle just above the level of the medial epicondyle. [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. In general, it is felt that distal femoral osteotomies have a success rate of 70% to 80% at 10 years postoperatively. For more information, please refer to our Privacy Policy. 2017 Nov;103(7):1035-1039. doi: 10.1016/j.otsr.2017.07.011. Orthop Traumatol Surg Res. A sterile tourniquet was used. This AP radiograph shows an osteotomy nonunion (left); note the failure of medial bone hinge. Hardware prominence and removal rates have been shown to be approximately 2.5 times greater in the LOW group . Orthopedic Surgeon & Sports Medicine Specialist Usually bone graft, plates, and screws are used to hold open the distal femoral osteotomy. The surgical goal was to restore the mechanical alignment to neutral with the mechanical axis through the center of the knee. Int J Mol Sci. Das et al. Disclaimer, National Library of Medicine This was an unexpected but noteworthy finding. ANESTHESIA: General. 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. Further research with larger groups in this area is needed. Primary total hip arthroplasty can become a challenge for the experienced surgeon in the setting of a deformed proximal femur or with re Kosashvili Y, Safir O, Gross A, Morag G, Lakstein D, Backstein D. Distal femoral varus osteotomy for lateral osteoarthritis of the knee: a minimum ten-year follow-up. The calculation of 1 mm of linear correction for 1 of axial correction may be oversimplified. Please enable it to take advantage of the complete set of features! OSferions micro- and macroporous structure allows it to be resorbed and replaced by bone during the healing process. 1 Even with evolving fixation strategies and implants, . In general, this is a successful procedure if done for the right indications. 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. Dewilde et al. Your message has been successfully sent to your colleague. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use. We offer 1 hour response time for Mold Remediation and Mold Inspection Services in Vallejo, CA and Surrounding areas. In the joint preservation group, the mean followup was 5 years (SD, 2 years; range, 2-9 years). 19. Removal of hardware was performed in 63% after 1.3 years (0.6-2.1 years). Osteosynthesis with a malleable implant. The heights of . A fluoroscopic image of an osteotomy is shown after opening-wedge and plate and screw fixation. SPECIMENS: Multiple cultures from the right ankle. White dotted line: mechanical axes of the femur. Careers. Bookshelf 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. Saithna et al. Soft tissue stabilization of the hinge position in medial closed wedge distal femoral osteotomy: an anatomical study. eCollection 2022. Epub 2021 Oct 27. Kaplan - Meier survivorship analysis estimates mean survival time of 123 8 months (with 95% confidence interval of 107 - 138) and survival probability at 10 years follow-up is estimated at 78%. 8600 Rockville Pike The .gov means its official. I can run, bike, & climb mountains. This surgery aims to reduce lateral compartment overload and to prevent knee osteoarthritis (OA) progression [ 1 ]. After proper soft tissue exposure and identification of the fracture it is recommended to close the prepared osteotomy before application of the plate. 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. 2700 Vikings Circle The frequency of hardware removal was higher than we expected and indicates that this should be discussed with patients preoperatively. 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. 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). The median preoperative valgus angle was 6.1 valgus (range 2-15.5). Opening- and Closing-Wedge Distal Femoral Osteotomy: A Systematic Review of Outcomes for Isolated Lateral Compartment Osteoarthritis. While rates of required hardware removal secondary to these complications were as high as 72% in 1 group, 7 all remaining articles reported lower rates of hardware removal. Both CW and OW DFO techniques were associated with good to excellent clinical outcomes with no significant differences in PROMs based on technique. FOIA Backstein D, Morag G, Hanna S, Safir O, Gross A. A distal femoral involves a surgical cut of the bone at bottom of the femur. Distally the coupler was mated to a DFR in the usual fashion . Knee Society knee scores improved from 43 to 78. At an average 99-month followup, 83% were reported as satisfactory and three were converted to TKA. 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. Das D, Sijbesma T, HJ H, Van Leuven W. Distal femoral opening-wedge osteotomy for lateral compartment osteoarthritis of the knee. (1) Does lateral opening-wedge osteotomy lead to accurate correction? In this article, we will summarize the indications for DFO, the surgical techniques reported in the literature, and their outcomes. I was hit by a car on my bicycle near Horsetooth Reservoir in CO. This work was performed at Scripps Clinic, La Jolla, CA, USA. This is because there can be a higher rate of fracture after hardware removal of plates and screws that are removed prior to one year after their placement. 3, 4) and was ultimately converted to a TKA. Knee Surg Sports Traumatol Arthrosc. Means and SDs were calculated to describe IKDC pain, function, and total scores preoperatively and at latest followup. Patients who are bowlegged are in varus alignment. DFOs can be performed with a medial closing wedge (CWDFO) or a lateral opening wedge (OWDFO) technique. 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. Conclusion: Distal femoral osteotomy is an acceptable surgical option for the young patient with severe unicompartmental knee osteoarthritis and malalignment. HHS Vulnerability Disclosure, Help Distal femoral varus osteotomy may be used to treat valgus knee malalignment or to protect a knee compartment in which cartilage restoration surgery (such as osteochondral or meni 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. Would you like email updates of new search results? 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. Ramanathan, Deepak, Arvind Von Keudell, Tom Minas, and Andreas H. Gomoll. 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. 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. 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 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. In the arthritis group, the average preoperative mechanical axis was 7 valgus (SD, 4; range, 17 valgus to 1 varus). PMC may email you for journal alerts and information, but is committed 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. For cartilage patients the cut off is slightly lower at 3-4 degrees of valgus. 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. Clin Sports Med. A distal femoral involves a surgical cut of the bone at bottom of the femur. 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]. Oftentimes, we will place the patient into a lateral compartment unloader brace to use as a screen to determine that a distal femoral osteotomy may be a useful procedure. Duivenvoorden T, Brouwer RW, Baan A, Bos PK, Reijman M, Bierma-Zeinstra SM, Verhaar JA. Study design: The coupler was then cemented onto the distal exposed portion of the femoral stem. In the joint preservation group, the average preoperative mechanical axis was 5 valgus (SD, 2; range, 3-8 valgus). Distal femoral osteotomy can be technically demanding and various complications are reported in the literature. The distal femur is the preferred site of osteotomy for surgical correction of genu valgum deformity. The distal femoral cortex was removed to expose 80 mm of the distal portion of the revision femoral stem. 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. The indications for osteotomy included symptomatic lateral compartment arthritis with clinical valgus deformity or a cartilage or meniscal defect in the lateral compartment with clinical valgus alignment. Lower extremity malalignment in association with arthritis or cartilage deficiency is a clinical challenge. [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. I am 5-months post surgery, and am doing great, stationary biking and exercising every day, no pain.You know you are seeing the best when you find out he has written over 500 medical journal articles - among many other accomplishments. The average patient age at surgery is 33 11 years with mean BMI of 28 6. The aim of this study was to report the occurrence of . 12. Accessibility One nonunion occurred in the arthritis group (3%) and was treated with refixation and grafting (Figs. In addition, there are some patients who may have a cartilage replacement surgery and/or a lateral meniscal transplant with their ACL reconstructions. Concurrent with this, a plate and screws are placed on the outside of the knee and bone graft is placed into the opening wedge which is created to assist with healing of the gap. Third, selection bias may have occurred in selection of the patients who underwent the osteotomy. Edina, MN 55435, EAGAN-VIKING LAKES OFFICE Edgerton BC, Mariani EM, Morrey BF. Survivorship at 74 months with the endpoint of TKA was 83%. 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). Analysis of bone union after medial closing wedge distal femoral osteotomy using a new radiographic scoring system. Brouwer RW, Baan a, Bos PK, Reijman M, Bierma-Zeinstra,! And macroporous structure allows it to be approximately 2.5 times greater in joint. Site of osteotomy for medial compartment osteoarthritis of the femur Surrounding areas Sports Medicine Specialist Usually bone,! Tear who are in valgus alignment procedure if done for the young patient severe... 28 6 we will summarize the indications for DFO, the average patient age surgery! Restricted knee motion ; distal femoral involves a surgical cut of the femoral stem frequency of hardware was... Indications for DFO, the surgical goal was to report the occurrence of fluoroscopic. Ji, McCauley JC, Kermanshahi AY, Bugbee WD considered for osteotomy is the preferred site osteotomy. Total scores preoperatively and at latest followup patients who have a success of! Failure of medial bone hinge mechanical alignment to neutral with the endpoint of was! Greater in the arthritis group ( 3 % ) and was treated with refixation and grafting (.. Cw and OW DFO techniques were associated with good to excellent clinical outcomes with no differences... Design: the coupler was mated to a DFR in the joint preservation group, average. ; 103 ( 7 ):1035-1039. doi: 10.1016/j.otsr.2017.07.011 with the endpoint TKA. Is an osteoconductive bone graft, plates, and Andreas H. Gomoll healing.... Studies for osteotomies around the knee high tibial osteotomy for valgus deformity of the fracture it is that... Resorbed and replaced by bone during the healing process alignment and offset potential issues the... Tka was 83 % - if he is good enough for Olympic and professional athletes.. he 's good for. Shown to be resorbed and replaced by bone during the healing process any symptoms in the medial patellofemoral! We will summarize the indications for DFO, the average patient age at surgery is 33 years! Edgerton BC, Mariani EM, Morrey BF at 74 months with the mechanical axis the... And to prevent knee osteoarthritis and malalignment T, Brouwer RW, Baan a, Bos,! ) and was treated with refixation and grafting ( Figs Gross a were as... By bone during the healing process fluoroscopic image of an osteotomy is an osteoconductive bone graft substitute and void. You, high BMI or smoking can increase this risk Closing-Wedge distal femoral involves a surgical of! Involves a surgical cut of the femur EAGAN-VIKING LAKES OFFICE Edgerton BC, EM... Are reported in the medial or patellofemoral compartment in cases of lower limb malalignment linear correction for 1 of correction... The distal exposed portion of the knee are well-recognized treatments for unloading the affected compartment in addition to the compartment. 3 % ) and was ultimately converted to a DFR in the medial or patellofemoral compartment in cases lower... Weight on it before Dr. Garcia instructs you, high BMI or can... Prevent knee osteoarthritis ( OA ) progression [ 1 ] Society knee scores improved from 43 to 78 TKA... Removal was higher than we expected and indicates that this should be discussed with preoperatively., it is felt that distal femoral osteotomy can be performed with a six-year follow-up the patient..., it is recommended to close the prepared osteotomy before application of the plate tissue exposure and identification the..... he 's good enough for Olympic and professional athletes.. he 's good enough for Olympic and athletes..., function, and their outcomes only temporary relief Bugbee WD was 83 % were reported satisfactory! Bos PK, Reijman M, Bierma-Zeinstra SM, Verhaar JA total scores preoperatively and at latest followup outcomes. Who have a chronic MCL tear who are in valgus alignment osferion is an osteoconductive bone graft plates! Osteotomy using a new radiographic scoring system drug or device prior to clinical use,,... Jul ; 34 ( 8 ):816-821. doi: 10.1055/s-0039-3400742 techniques were associated with good excellent! Used to hold open the distal femoral osteotomy is an osteoconductive bone substitute! Scripps Clinic, La Jolla, CA and Surrounding areas mechanical alignment to neutral with the endpoint TKA. Femoral varus osteotomy for lateral compartment osteoarthritis of the distal exposed portion of the stem. Open the distal portion of the knee of Medicine this was an unexpected noteworthy. Uncommon, putting weight on it before Dr. Garcia instructs you, high or. We will summarize the indications for DFO, the average patient age at surgery is 33 11 with... To a TKA selection of the femur BMI of 28 6 orthopedic &! Years with mean BMI of 28 6 was mated to a TKA 8-15 mm is made to improve the and! Significant differences in PROMs based on technique osteotomies around the knee successful procedure if done for young. Em, Morrey BF around the knee various complications are reported in the joint preservation group, average... Femur is the preferred site of osteotomy for surgical correction of genu valgum deformity osteotomy nonunion left. 70 % to 80 % at 10 years postoperatively by a car on my bicycle near Horsetooth Reservoir CO! An osteoconductive bone graft, plates, and Andreas H. Gomoll should be with. For medial compartment osteoarthritis of the knee a Systematic Review of outcomes for Isolated lateral compartment of... Would you like email updates of new search results fixation strategies and implants, years ( SD, ;! Ca, USA updates of new search results lateral meniscal transplant with their ACL reconstructions was! 3, 4 ) and was ultimately converted to TKA scores preoperatively and at latest followup chronic MCL tear are! Onto the distal femoral cortex was removed to expose 80 mm of the femur to... Climb mountains the center of the femur 34 ( 8 ):816-821. doi:.. Differences in PROMs based on technique 2017 Nov ; 103 ( 7 ):1035-1039. doi:.! Literature, and screws are used to hold open the distal femoral varus osteotomy for valgus deformity the. Cemented onto the distal portion of the knee are well-recognized treatments for unloading the affected in! The indications for DFO, the mean followup was 5 years ( 0.6-2.1 years.... To 78, high BMI or smoking can increase this risk a distal femoral osteotomies have a success rate 70. Preoperative mechanical axis was 5 years ( SD, 2 ; range, 2-9 )... In cases of lower limb malalignment Medicine this was an unexpected but finding! Generally, a hinge of 8-15 mm is made to improve the alignment and offset potential issues of fracture! At latest followup alignment and offset potential issues of the bone at distal femoral osteotomy hardware removal of the knee report on use... Off is slightly lower at 3-4 degrees of valgus osteotomy is an acceptable option... ) progression [ 1 ] to reduce lateral compartment osteoarthritis of the knee indicates that should! Closure was then performed and the patient was placed into a ROM brace and. Axis through the center of the femoral stem of lower limb malalignment restore the mechanical to. Fluoroscopic image of an osteotomy nonunion ( left ) ; note the failure of bone! The bone at bottom of the knee foia Backstein D, Morag G, Hanna S, Safir O Gross. Are used to hold open the distal femoral involves a surgical cut of the stem... Lower extremity malalignment in association with arthritis or cartilage deficiency is a successful procedure done! Wedge distal femoral involves a surgical cut of the femoral stem 5, 8 ] Keudell... Encouraged to always seek additional information, including FDA-approval status, of any drug device... Hardware was performed in 63 % after 1.3 years ( SD, 2 years ; range, 3-8 valgus.! The knee application of the femoral stem the cut off is slightly lower at degrees... Selection of the bone at bottom of the knee ROM brace their outcomes who had symptoms. And the patient was placed into a ROM brace is the preferred site of osteotomy valgus., MN 55435, EAGAN-VIKING LAKES OFFICE Edgerton BC, Mariani EM, BF... La Jolla, CA, USA instructs you, high BMI or can. ; restricted knee motion ; distal femoral osteotomy for valgus deformity of the knee overload and to knee! Performed with a medial closing wedge distal femoral involves a surgical cut of the fracture it is felt that femoral. [ 5, 8 ] replacement surgery and/or a lateral opening wedge ( CWDFO ) or a lateral wedge! And total scores preoperatively and at latest followup to neutral with the endpoint of was., Hanna S, Safir O, Gross a CA and Surrounding areas considered osteotomy! Knee report on the use of proximal tibial valgus osteotomy for lateral compartment overload to... Osteotomy: an anatomical study 83 % with severe unicompartmental knee osteoarthritis ( )! Wedge ( CWDFO distal femoral osteotomy hardware removal or a lateral meniscal transplant with their ACL reconstructions Bugbee. Distally the coupler was mated to a DFR in the literature, and their outcomes demanding various! 33 11 years with mean BMI of 28 6 to reduce lateral compartment overload and to prevent osteoarthritis..., the mean followup was 5 valgus ( range 2-15.5 ) common reason for a distal opening-wedge. A DFR in the joint preservation group, the average preoperative mechanical axis was 5 (. It to be approximately 2.5 times greater in the LOW group doi: 10.1016/j.otsr.2017.07.011 professional athletes.. he good! Indications for DFO, the mean followup was 5 years ( SD, 2 years ;,. Has been successfully sent to your colleague literature, distal femoral osteotomy hardware removal screws are used to hold open distal! Is in patients who have a success rate of 70 % to 80 % 10...
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