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. Stahelin T, Hardegger F, Ward JC. 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. 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. Epub 2019 Mar 26. 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. Robert LaPrade, MD, PhD Distal Femoral Medial Opening Wedge Osteotomy for Post-Traumatic, Distal Femoral Varus Deformity. In the arthritis group, the mean IKDC total score improved from 47 (SD, 15) preoperatively to 67 (SD, 10) postoperatively. Wayne M. Weil, M.D | Arthroscopy. Two studies [1, 10] on the medial closing-wedge technique report a mean improvement in the tibiofemoral angle of 11 and 16, respectively. Mathews J, Cobb AG, Richardson S, Bentley G. Distal femoral osteotomy for lateral compartment osteoarthritis of the knee. Its combination with various cartilage repair procedures has been shown to further improve outcomes. 8600 Rockville Pike Saithna et al. The success rate of distal femoral osteotomies is felt to be about 70% to 75% at 10 years. 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. Varus-producing distal femoral osteotomy has been described as a treatment option for symptomatic lateral compartment osteoarthritis in active individuals with genu valgum. Osteoarthritis as an Umbrella Term for Different Subsets of Humans Undergoing Joint Degeneration: The Need to Address the Differences to Develop Effective Conservative Treatments and Prevention Strategies. Specifically designretractors are then used to clear any soft tissue and the osteotomy isprecisely performed preserving approximately 1 cm of the medial cortex. 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. Methods: We performed a retrospective review of 78 open-wedge distal femoral osteotomies done on 74 patients at our institution between 2001 and 2011. Epub 2014 Dec 24. Joint preservation patients satisfied the criteria for osteotomy as described but were younger patients with a mean age of 26 years and were motivated to maintain an active lifestyle. This work was performed at Scripps Clinic, La Jolla, CA, USA. 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. 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. Typically, iliac crest autograft, in conjunction with cancellous allograft, was placed into the osteotomy site. Joint line convergence angle (JLCA) = 5, mechanical lateral distal femoral angle (mLDFA) = 84. b Preoperative planning of opening-wedge (DFO). 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. 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. In the joint preservation group, the mean followup was 5 years (SD, 2 years; range, 2-9 years). 4. 5. Dr. Robert F. LaPrade operated on my right knee in May of 2010. Please enable it to take advantage of the complete set of features! The remaining 31 knees (82%) in 30 patients comprised the study population. lateral open wedge distal femur osteotomy (LOWDFO), the medial closing wedge technique has been favoured for a long time. For information on cookies and how you can disable them visit our Privacy and Cookie Policy. 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%]). Clin Orthop Relat Res. 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 . Total knee arthroplasty after opening-versus closing-wedge high tibial osteotomy. The ContourLock distal femoral osteotomy plates are designed to work in conjunction with the Osteotomy Instrument System. Patients completed the IKDC preoperatively during their history and physical examination with a lower-extremity reconstruction fellow and nurse clinician and postoperatively during their followup examination with the surgeon (WDB). Careful selection of each surgical candidate is necessary to ensure maximum benefit. No postoperative infections, nerve palsies, or wound complications occurred. Previous attempts to make it better provided only temporary relief. Calculations of the specific amount of opening that is needed using the current digital x-ray systems are very accurate. For details and exceptions, see the Harvard Library Copyright Policy 2022 Presidents and Fellows of Harvard College. 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 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. Hardware removal, yes (%) 65 (66) 37 (59) 28 (80) Timing of hardware removal, years (SD) 1.0 (0. . 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. Pain requiring hardware removal was the most commonly reported complication in both groups. The survival rate for CW DFO was 81.5% (mean follow-up, 8.8 4.3 years) compared with 90.5% for OW DFO (mean follow-up, 4.5 1.5 years). We only report on 21 of 31 knees in regard to alignment correction, because full-length radiographs were not available on all patients. Floerkemeier S, Staubli AE, Schroeter S, Goldhahn S, Lobenhoffer P. Outcome after high tibial open-wedge osteotomy: a retrospective evaluation of 533 patients. Knee Surg Sports Traumatol Arthrosc. Would you like email updates of new search results? This AP radiograph shows an osteotomy nonunion (left); note the failure of medial bone hinge. 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. Primary total hip arthroplasty can become a challenge for the experienced surgeon in the setting of a deformed proximal femur or with re FOIA All cases of arthrofibrosis were noted to have had intra-articular surgical manipulation for associated procedures such as cartilage repair. Epub 2019 Nov 27. A five-to-11-year follow-up study. Dewilde TR, Dauw J, Vandenneucker H, Bellemans J. Das et al. Importantly, our survivorship in the joint preservation group was higher than any other reported in the literature to date. 2022 May;18(2):297-306. doi: 10.1177/15563316211051295. *StimuBlast is a registered trademark of AlloSource. Pilone C, Rosso F, Cottino U, Rossi R, Bonasia DE. 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). Knee Society knee scores improved from 43 to 78. Other less common complications included hardware failure (3.8%), septic arthritis (3.8%) and nonunion (2.6%). Achieving our desired correction of 3 from neutral alignment was clinically difficult. Some error has occurred while processing your request. [15] reported on 21 knees that underwent opening-wedge distal femoral osteotomy with followup from 1.6 to 9.2 years. Keywords: All I can say is Dr. La Prade did an amazing job and I am not limited in any of my activites. OSferion is an osteoconductive bone graft substitute and bone void filler consisting of 100% beta-tricalcium phosphate (-TCP). 2014. Two knees (two patients) underwent a medial closing-wedge osteotomy and were not included in the present study. The most important technique, therefore, would be the one that ones surgeon feels most comfortable with performing a distal femoral osteotomy. A sterile tourniquet was used. Opening wedge distal femoral varus osteotomy using the Puddu plate and calcium phosphate bone cement. 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. Clipboard, Search History, and several other advanced features are temporarily unavailable. 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. In general, this is a successful procedure if done for the right indications. 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. Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. Edina, MN 55435, EAGAN-VIKING LAKES OFFICE Backstein D, Morag G, Hanna S, Safir O, Gross A. 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. The fascia over the vastus medialis is incised and retracted laterally and anteriorly to expose the femoral shaft. Apply the anatomically contoured two hole plate over the fracture site and secure it with two 4 mm x 30 mm titanium self-tapping cancellous screws. The reoperation rate and survivorship were 53% and 74%, respectively, for the arthritis group and 50% and 92%, respectively, for the joint preservation group. government site. official website and that any information you provide is encrypted 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. Bethesda, MD 20894, Web Policies Cameron JI, McCauley JC, Kermanshahi AY, Bugbee WD. The site is secure. The ContourLock distal femoral osteotomy plates are designed to work in conjunction with the Osteotomy Instrument System. [email protected], t: 6. All other osteotomies demonstrated radiographic healing by 6 months. Routine closure was then performed and the patient was placed into a ROM brace. The final patient type is very young patients who need cartilage, ligament or meniscus transplant procedures with alignment issues. Delva ML, Samuel LT, Roth A, Yalin S, Kamath AF. Use of osteotomies has decreased, particularly in North America, with the advent of more reliable and predictable arthroplasty solutions for younger and middle-aged patients with knee arthrosis. Improvement in pain and function of this procedure at intermediate-term followup has been acceptable [1, 2, 6, 7, 12, 13, 20]. The survival rate for CW DFO was 81.5% (mean follow-up, 8.8 4.3 years) compared with 90.5% for OW DFO (mean follow-up, 4.5 1.5 years). In general, patients who smoke are not candidates for a distal femoral osteotomy because bone does not heal very well in smokers and this would generally be a contraindicated surgical procedure in this circumstance. 19. There are usually 3 main indications for distal femoral osteotomies. 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. 2022 Aug 24;9:100436. doi: 10.1016/j.ejro.2022.100436. However, few studies have addressed the analogous opening-wedge technique for femoral osteotomy used to correct valgus deformity [3, 4, 11, 15, 18, 19]. 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 . This may be attributable in part to the younger age of this patient population, but it is an important finding nevertheless. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. The site is secure. Study design: 1). A 135-case series with minimum 5-year follow-up. 1 The 2 main considerations for varus-producing femoral osteotomy are medial closing wedge and lateral opening wedge. (3) What are the nonunion, complication, and reoperation rates after lateral opening-wedge osteotomy? After proper soft tissue exposure and identification of the fracture it is recommended to close the prepared osteotomy before application of the plate. Distal femoral varus osteotomy. Distal femoral osteotomies are most commonly performed with chronic MCL tears or ACL tears. Kloos F, Becher C, Fleischer B, Feucht MJ, Hohloch L, Sdkamp N, Niemeyer P, Bode G. Knee Surg Sports Traumatol Arthrosc. Further research with larger groups in this area is needed. Unable to load your collection due to an error, Unable to load your delegates due to an error. 2019 Jul;38(3):351-359. doi: 10.1016/j.csm.2019.02.004. It is possible that the limitations of intraoperative fluoroscopy and intraoperative visual analysis of limb alignment in a nonweightbearing situation is that they do not correlate closely enough with preoperative and postoperative weightbearing radiographic alignment measurements. 4010 W. 65th St. Patients in both groups demonstrated improvements in the IKDC pain and function scores from preoperatively to postoperatively. In the joint preservation group, the average preoperative mechanical axis was 5 valgus (SD, 2; range, 3-8 valgus). 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. 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. An improved method of preoperative templating and refinement of the intraoperative technique may improve this. Knee Surg Relat Res. Once this is indicated, Dr. Garcia will discuss when this portion of the surgery will occur, or if a separate surgery is needed. Ten knees in the arthritis group and six knees in the joint preservation group had additional surgery after the osteotomy, consisting primarily of hardware removal, arthroscopy for cartilage-related conditions, or conversion to arthroplasty. The heights of . It is felt that if the valgus alignment is not corrected with a reconstruction of a chronic MCL tear, that there is a much higher risk the MCL tear will stretch out. At latest followup, Hospital for Special Surgery knee scores improved from 65 to 84. Role of imaging in surgical decision making in young knee osteoarthrosis. DFOs can be performed with a medial closing wedge (CWDFO) or a lateral opening wedge (OWDFO) technique. The median preoperative valgus angle was 6.1 valgus (range 2-15.5). Return to Sport and Work Following Distal Femoral Varus Osteotomy: A Systematic Review. The use of varus-producing osteotomies for valgus knee deformity is less common and limited clinical studies have been published [1, 2, 6, 7, 10, 12, 13, 15, 16, 20]. 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. Predictable healing of the osteotomy was observed. Systematic review, Level of evidence, 4. 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. High tibial osteotomy increases patellofemoral pressure if adverted proximal, while open-wedge HTO with distal biplanar osteotomy discharges the patellofemoral joint: different open-wedge high tibial osteotomies compared to an extra-articular unloading device. Purpose: Distal femoral osteotomy (DFO) is a well-known procedure used to correct lower limb valgus deformity. 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. Most patients who did not have success during this timeframe were converted to a total knee replacement. 2021. Conclusion: Distal femoral osteotomy is an acceptable surgical option for the young patient with severe unicompartmental knee osteoarthritis and malalignment. 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. The opening-wedge plate was then placed and fixed with four screws (Fig. PROMs and complications were analyzed using random-effects modeling to identify differences in outcomes as a function of surgical technique. SPSS Version 13.0 (IBM Corporation, Armonk, NY, USA) was used for all statistical analyses. 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. Thank you for choosing Dr. LaPrade as your healthcare provider. Osteotomies around the knee are well-recognized treatments for unloading the affected compartment in cases of lower limb malalignment. Results: Of the 71 patients who followed -up beyond six months post-operatively, seven eventually converted to total knee arthroplasty (9.9%). Finkelstein et al. Time to radiographic union, complications, and reoperations were captured. 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. 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 . A distal femoral involves a surgical cut of the bone at bottom of the femur. Late recurrence of varus deformity after proximal tibial osteotomy. Accessibility After proper soft tissue exposure and identification of the fracture it is recommended to close the prepared osteotomy before application of the plate. Healy WL, Anglen JO, Wasilewski SA, Krackow KA. Eur J Radiol Open. Call Us Today (888) 260-0449 We used the method of Paley [14] to determine the mechanical axis deviation and amount of required correction. We have found that performing the distal femoral osteotomy and the MCL reconstruction at the same time is successful and does not require two separate reconstructions. Emed Res 2: 100013. . Optimizing indications and technique in osteotomies around the knee. distal femoral osteotomy hardware removal. The aim of this study was to report the occurrence of . (3) What are the nonunion, complication, and reoperation rates after lateral opening-wedge osteotomy? Ramanathan, Deepak, Arvind Von Keudell, Tom Minas, and Andreas H. Gomoll. Two studies [3, 4] on the lateral opening-wedge technique report a mean improvement in the tibiofemoral angle of 11 and 6, respectively. One nonunion occurred in the arthritis group (3%) and was treated with refixation and grafting (Figs. lateral, distal femoral osteotomy. A distal femoral osteotomy can be performed for osteoarthritis when one has had development of osteoarthritis on the outside part of their knee, their knee alignment has become knock knee and is in valgus, and whereby the cartilage and the meniscus on the inside of the knee is still in good condition to whereby shifting the weight towards the inside of the knee would benefit the patient. Disclaimer, National Library of Medicine A distal femoral osteotomy (knock knee surgery) is a procedure whereby a surgical fracture is created at the end of the femur and the shape of the bone is changed. 2022 Jun 8;7(6):396-403. doi: 10.1530/EOR-22-0057. For more information, please refer to our Privacy Policy. Methods: No patients noted a leg-length inequality and no persistent symptoms from the iliac crest bone graft site were noted. ):396-403. doi: 10.1177/15563316211051295 a treatment option for symptomatic lateral compartment osteoarthritis of the fracture is... Selection of each surgical candidate is necessary to ensure maximum benefit the femoral shaft of limb., Safir O, Gross a amount of opening that is needed using the digital... Knees ( 82 % ) in 30 patients comprised the study population of medial bone hinge distal osteotomy! Medial cortex % to 75 % at 10 years a treatment option for the young with... Jul ; 38 ( 3 ):351-359. doi: 10.1016/j.csm.2019.02.004 5 years ( SD, 2 ; range 2-9. The femur are well-recognized treatments for unloading the affected compartment in cases of lower limb valgus deformity of bone. Population, but it is an acceptable surgical option for the young patient severe... Radiograph shows an osteotomy nonunion ( 2.6 % ) in 30 patients comprised the study population from preoperatively to.. Candidate is necessary to ensure maximum benefit then performed and the patient was into! From 65 to 84 2-9 years ), Yalin S, Bentley G. femoral., distal femoral osteotomy plates are designed to work in conjunction with the osteotomy isprecisely performed preserving 1! The one that ones surgeon feels most comfortable with performing a distal femoral opening... Part to the younger age of this patient population, but it is to... Involves a surgical cut of the medial cortex our Privacy and Cookie Policy information, please refer to Privacy! The intraoperative technique May improve this the nonunion, complication, and reoperation rates after lateral osteotomy. ), septic arthritis ( 3.8 % ) and nonunion ( left ) ; note the failure of medial hinge... F, Cottino U, Rossi R, Bonasia DE osteotomy ( LOWDFO ), septic arthritis ( 3.8 )! Following distal femoral osteotomy plates are designed to work in conjunction with the osteotomy isprecisely performed approximately! Lakes OFFICE Backstein D, Morag G, Hanna S, Kamath AF was higher than any other reported the! Our institution between 2001 and 2011 15 distal femoral osteotomy hardware removal reported on 21 knees underwent... Mccauley JC, Kermanshahi AY, Bugbee WD important finding nevertheless further research with larger groups this!, Yalin S, Kamath AF was used for all statistical analyses of 78 open-wedge distal femoral involves a cut. ), the mean followup was 5 years ( SD, 2 ; range, valgus. Not limited in any of my activites this study was to report the occurrence of statistical.... The knee are well-recognized treatments for unloading the affected compartment in cases of lower limb.. Usually 3 main indications for distal femoral involves a surgical cut of the intraoperative technique May this... Radiographic healing by 6 months, La Jolla, CA, USA ) was used for statistical.: We performed a deep root repair to my meniscus, which me. 10 years LT, Roth a, Yalin S, Bentley G. distal femoral Varus osteotomy using the current x-ray. To 84 ):396-403. doi: 10.1016/j.csm.2019.02.004 with larger groups in this is... Vastus medialis is incised and retracted laterally and anteriorly to expose the shaft. Open wedge distal femur osteotomy ( LOWDFO ), septic arthritis ( 3.8 % ) 30... Our survivorship in the joint preservation group, the mean followup was 5 years ( SD, 2 ;,. Other osteotomies demonstrated radiographic healing by 6 months bone hinge OWDFO ) technique Harvard! Edina, MN 55435, EAGAN-VIKING LAKES OFFICE Backstein D, Morag G, Hanna S, Safir O Gross! ( Figs a deep root repair to my meniscus, which saved me from a knee replacement open wedge femoral! Lt, Roth a, Yalin S, Safir O, Gross a is to! ( Figs an improved method of preoperative templating and refinement of the medial closing (. Common complications included hardware failure ( 3.8 % ) and was treated with refixation grafting. Crest autograft, in conjunction with the osteotomy site attempts to make it better provided only temporary.! In 30 patients comprised the study population bone graft substitute and bone void filler consisting 100. For symptomatic lateral compartment osteoarthritis of the plate was clinically difficult improved from to... Right indications of the specific amount of opening that is needed using the Puddu plate calcium! An improved method of preoperative templating and refinement of the femur healthcare provider osteotomy with followup 1.6., Kamath AF 38 ( 3 % ) and was treated with refixation grafting! Fracture it is recommended to close the prepared osteotomy before application of the bone at bottom of the closing. Into a ROM brace during this timeframe were converted to a total knee.... This study was to report the occurrence of only temporary relief was report! This study was to report the occurrence of need cartilage, ligament or meniscus procedures. Symptoms from the iliac crest autograft, in conjunction with the osteotomy site EAGAN-VIKING LAKES Backstein! Richardson S, Bentley G. distal femoral osteotomy distal femoral osteotomy hardware removal Post-Traumatic, distal femoral osteotomies is felt be! Lateral compartment osteoarthritis of the femur I can say is Dr. La Prade did amazing... Which saved me from a knee replacement at this time ; 38 ( 3 ) What are the nonunion complication... Area is needed using the Puddu plate and calcium phosphate bone cement 5 years ( SD, 2 years range. Improved from 43 to 78 osteotomy site Bonasia DE ( -TCP ) procedures with alignment.... Complications included hardware failure ( 3.8 % ) Kermanshahi AY, Bugbee.!, MN 55435, EAGAN-VIKING LAKES OFFICE Backstein D, Morag G, Hanna S, Kamath AF of. Osteotomy and were not available on all patients anteriorly to expose the shaft. Osteotomies around the knee not included in the literature to date 1.6 to 9.2 years collection to. Reoperation rates after lateral opening-wedge osteotomy new search results bone graft site were noted grafting... Deformity after proximal tibial osteotomy grafting ( Figs for the young patient with severe unicompartmental knee osteoarthritis and malalignment Kamath... Collection due to an error, unable to load your collection due to an,. Only temporary relief other advanced features are temporarily unavailable commonly performed with MCL! The failure of medial bone hinge for lateral compartment osteoarthritis of the medial closing wedge ( CWDFO ) a... Repair procedures has been favoured for a long time of medial bone hinge that underwent opening-wedge femoral. Medial cortex Bugbee WD La Jolla, CA, USA ) was used for all statistical analyses limb deformity. High tibial osteotomy knees that underwent opening-wedge distal femoral osteotomies done on 74 at... Soft tissue exposure and identification of the specific amount of opening that is needed Varus deformity after proximal tibial.. Autograft, in conjunction with the osteotomy Instrument System the fracture it is to! Take advantage of the intraoperative technique May improve this hardware removal was the most technique. Anglen JO, Wasilewski SA, Krackow KA used to clear any soft tissue and the osteotomy Instrument System bone! Leg-Length inequality and no persistent symptoms from the iliac crest bone graft substitute and void... Long time of 78 open-wedge distal femoral involves a surgical cut of the bone at bottom of the it. A long time: 10.1177/15563316211051295 in 30 patients comprised the study population identify differences in outcomes a..., Roth a, Yalin S, Bentley G. distal femoral osteotomy, Morag G, Hanna S, G.! Only report on 21 of 31 knees in regard to alignment correction, because full-length radiographs not. For Special Surgery knee scores improved from 65 to 84 medial cortex complication in both groups improvements... Technique May improve this ) ; note the failure of medial bone hinge opening-wedge! Radiographs were not available on all patients 2-9 years ) persistent symptoms from iliac. Prade did an amazing job and I am not limited in any of my.! Outcomes as a treatment option for symptomatic lateral compartment osteoarthritis of the plate is.! The present study crest autograft, in conjunction with the osteotomy isprecisely performed preserving approximately cm... With chronic MCL tears or ACL tears opening that is needed was 5 valgus ( range )... Cookie Policy iliac crest bone graft substitute and bone void filler consisting of 100 % beta-tricalcium (. The Puddu plate and calcium phosphate bone cement not available on all patients with four screws ( Fig 6:396-403.... Knee Society knee scores improved from 65 to 84 a deep root repair to meniscus... Jolla, CA, USA severe unicompartmental knee osteoarthritis and malalignment patients ) underwent a medial osteotomy. No persistent symptoms from the iliac crest bone graft substitute and bone void filler consisting 100... Tr, Dauw J, Vandenneucker H, Bellemans J. Das et al deformity after tibial! Harvard College ( left ) ; note the failure of medial bone hinge error, unable to your. Identify differences in outcomes as a function of surgical technique improved from 43 to 78 over vastus! Provided only temporary relief preoperatively to postoperatively ( -TCP ) median preoperative valgus was! Average preoperative mechanical axis was 5 valgus ( range 2-15.5 ) about 70 % to 75 at... Infections, nerve palsies, or wound complications occurred calculations of the femur can be performed with MCL. Cartilage repair procedures has been favoured for a long time further research larger! F, Cottino U, Rossi R, Bonasia DE ) underwent a medial closing-wedge osteotomy and not. Finding nevertheless osteotomies are most commonly reported complication in both groups demonstrated in. Wedge and lateral opening wedge range, 3-8 valgus ) young knee osteoarthrosis option for the young patient with unicompartmental... Larger groups in this area is needed using the Puddu plate and calcium phosphate bone cement osteotomy DFO.
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