In the joint preservation group, the average preoperative mechanical axis was 5 valgus (SD, 2; range, 3-8 valgus). A distal femoral involves a surgical cut of the bone at bottom of the femur. In addition, there are some patients who may have a cartilage replacement surgery and/or a lateral meniscal transplant with their ACL reconstructions. The aim of this study was to report the occurrence of . [16] reported on 21 medial closing-wedge osteotomies in 19 patients with a mean age of 57 years at 2- to 12-year followup. Usually bone graft, plates, and screws are used to hold open the distal femoral osteotomy. Intraoperative fluoroscopic and visual analysis of correction to neutral mechanical axis is not as accurate as we had anticipated. 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. Hardware prominence and removal rates have been shown to be approximately 2.5 times greater in the LOW group . 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%]). http://dx.doi.org/10.1177/2325967114S00051. Isolated high tibial osteotomy is appropriate in less than two-thirds of varus knees if excessive overcorrection of the medial proximal tibial angle should be avoided. Mathews J, Cobb AG, Richardson S, Bentley G. Distal femoral osteotomy for lateral compartment osteoarthritis of the knee. 18. However, osteoarthritis continues to progress and multiple arthroscopic or open procedures may be required despite a successful osteotomy. This surgery aims to reduce lateral compartment overload and to prevent knee osteoarthritis (OA) progression [ 1 ]. Routine closure was then performed and the patient was placed into a ROM brace. Lateral opening-wedge distal femoral osteotomy was less accurate in correction of valgus deformity than we expected, but the procedure was associated with improved pain and function and a 5-year survivorship of 74% and 92% in the arthritis and joint preservation patient cohorts, respectively. Hey - if he is good enough for Olympic and professional athletes..he's good enough for me! 2019 Jul;38(3):351-359. doi: 10.1016/j.csm.2019.02.004. Phil Downer, M.D | Orthopedic Surgeon & Sports Medicine Specialist Duivenvoorden T, Brouwer RW, Baan A, Bos PK, Reijman M, Bierma-Zeinstra SM, Verhaar JA. 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. pt13: proximal femoral plate removal pt14: chiari pelvic osteotomy (child with neurological impairment) pt15: san diego / degas pelvic osteotomy (child with neurological impairment) pt16: distal femoral rotational osteotomy pt17: distal tibial rotational osteotomy pt18: evan's calcaneal lengthening pt19: triple arthrodesis pt20: botox . Methods: We performed a retrospective review of 78 open-wedge distal femoral osteotomies done on 74 patients at our institution between 2001 and 2011. Contemporary Knee Osteotomy in the United States: High Tibial Osteotomy and Distal Femoral Osteotomy Have Comparable Complication Rates despite Differing Demographic Profiles. Saithna et al. Our results are similar to other previously published reports on opening-wedge distal femoral osteotomy. The remaining 31 knees (82%) in 30 patients comprised the study population. 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. official website and that any information you provide is encrypted 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. When the amount of planned correction was obtained at the osteotomy site, lateral fluoroscopic images were obtained to ensure there was no flexion or extension of the osteotomy. As part of the planning for a distal femoral osteotomy, we like to put most of our patients into a lateral compartment unloader brace. Inclusion criteria consisted of studies reporting outcomes in patients undergoing CW or OW DFO for the treatment of valgus knee deformities with symptomatic lateral compartment pathology with a minimum 2-year follow-up. Correction of valgus knee deformity with a supracondylar V osteotomy. 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]. The site is secure. The surgical goal was to restore the mechanical alignment to neutral with the mechanical axis through the center of the knee. [3] reported on 12 patients with an average age of 52 years undergoing opening-wedge distal femoral osteotomy with the Puddu plate. Characteristics of the arthritis and the joint preservation groups. Its combination with various cartilage repair procedures has been shown to further improve outcomes. Means and SDs were calculated to describe IKDC pain, function, and total scores preoperatively and at latest followup. Conclusion: Distal femoral osteotomy is an acceptable surgical option for the young patient with severe unicompartmental knee osteoarthritis and malalignment. Seattle Shoulder Surgery | 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. Means and frequencies were calculated to describe patient characteristics of the study population, type of fixation and graft material, amount of intraoperative correction, and mechanical axis alignment. Both CW and OW DFO techniques were associated with good to excellent clinical outcomes with no significant differences in PROMs based on technique. Routine radiographs of the osteotomy site were obtained at followups as well as postoperative long-limb alignment radiographs when possible. Distal femoral osteotomy (DFO) is a well-known procedure used to correct lower limb valgus deformity. 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. [15] reported on 21 knees that underwent opening-wedge distal femoral osteotomy with followup from 1.6 to 9.2 years. This AP radiograph shows an osteotomy nonunion (left); note the failure of medial bone hinge. Long-term survival data, defined as conversion to total knee arthroplasty, were analyzed using a multiple metaregression model as a function of individual study follow-up time points and surgical technique. There are usually 3 main indications for distal femoral osteotomies. The final patient type is very young patients who need cartilage, ligament or meniscus transplant procedures with alignment issues. EDINA- CROSSTOWN OFFICE Survivorship at 10, 15, and 20 years was 90%, 79%, and 21.5%, respectively. Federal government websites often end in .gov or .mil. Lower extremity malalignment in association with arthritis or cartilage deficiency is a clinical challenge. Clin Orthop Relat Res. Keywords: Das D, Sijbesma T, HJ H, Van Leuven W. Distal femoral opening-wedge osteotomy for lateral compartment osteoarthritis of the knee. I was told by one of the orthopedic surgeons that I worked with that I would never run again and would be lucky if I could ever hike again. Please enable scripts and reload this page. For larger procedures in younger patient full recovery may take longer based on the other procedures performed. 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). Preoperative planning on long-leg x-rays. The study population was stratified into two groups based on reason for osteotomy: patients with isolated symptomatic lateral compartment arthritis (arthritis group; 19 knees [61%]) and patients who underwent joint preservation procedures including osteochondral allograft transplantation or meniscal allograft transplantation (joint preservation group; 12 knees [39%]) (Table 1). 2019 Jul;27(7):2334-2344. doi: 10.1007/s00167-018-5194-x. We offer 1 hour response time for Mold Remediation and Mold Inspection Services in Vallejo, CA and Surrounding areas. An official website of the United States government. The average patient age at surgery is 33 11 years with mean BMI of 28 6. 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. Care was taken to maintain the line above the articular surface of the trochlea. 2022 Sep;142(9):2303-2312. doi: 10.1007/s00402-022-04495-1. Opening wedge distal femoral varus osteotomy using the Puddu plate and calcium phosphate bone cement. PMC Twenty-one of 31 knees had postoperative radiographic data available for review. 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. Results: The coupler was then cemented onto the distal exposed portion of the femoral stem. Indications and Contraindications Indications Moderate corrections up to 10 degrees for opening wedge Larger corrections from 12 to 27 degrees for closing wedge Lateral compartment mild to moderate osteoarthritis Lateral condyle cartilage lesions (with or without cartilage restoration) 4. Previous attempts to make it better provided only temporary relief. All I can say is Dr. La Prade did an amazing job and I am not limited in any of my activites. 8600 Rockville Pike 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. 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. Careful selection of each surgical candidate is necessary to ensure maximum benefit. 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. The frequency of hardware removal was higher than we expected and indicates that this should be discussed with patients preoperatively. These studies report the correction of deformity and the pain and function of small cohorts of patients undergoing a medial closing-wedge distal femoral osteotomy for treatment of lateral compartment arthritis. While this is very uncommon, putting weight on it before Dr. Garcia instructs you, high BMI or smoking can increase this risk. The most common complication was hardware pain (20.5%) followed by arthrofibrosis (12.8%). Eberbach H, Mehl J, Feucht MJ, Bode G, Sdkamp NP, Niemeyer P. Am J Sports Med. Accessibility This realignment moves the force on the arthritis part of the knee to the normal part. This is what this term means. 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. Wang and Hsu [20] reported on 30 knees undergoing varus osteotomy with a medial blade plate. The ContourLock distal femoral osteotomy plates are designed to work in conjunction with the Osteotomy Instrument System. Improvement in pain and function of this procedure at intermediate-term followup has been acceptable [1, 2, 6, 7, 12, 13, 20]. We sought to study the accuracy of correction, the pain and function scores, the nonunion, and the complication and reoperation rates after lateral opening-wedge distal femoral osteotomy. Delva ML, Samuel LT, Roth A, Yalin S, Kamath AF. 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. Kloos F, Becher C, Fleischer B, Feucht MJ, Hohloch L, Sdkamp N, Niemeyer P, Bode G. Knee Surg Sports Traumatol Arthrosc. 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). Pilone C, Rosso F, Cottino U, Rossi R, Bonasia DE. Of these, seven of 15 knees in the arthritis group and three of six knees in the joint preservation group were within the correction goal of 3 from neutral mechanical alignment. 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. a Preoperative long-leg standing X-rays. 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. 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. Our study had several limitations. 2019. Study design: No studies in the literature to date have reported on opening-wedge distal femoral osteotomy in joint preservation procedures. However, with renewed interest in biologic restoration and the use of cartilage restoration techniques, osteotomies have seen an increase in popularity, particularly in younger (age 25-40 years) patients. Terry GC, Cimino PM. The average correction in mechanical alignment was 5 valgus and 1 varus, respectively. Unable to load your collection due to an error, Unable to load your delegates due to an error. Please try again soon. Please try after some time. 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. 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. They also reported two cases of loss of correction, one infection, and one nonunion. Once the osteotomy was mobile, an opening-wedge device was placed. Stahelin T, Hardegger F, Ward JC. MeSH A comment to this article is available at http://dx.doi.org/10.1007/s11999-015-4159-3. In general, it is felt that younger patients definitively should have a distal femoral osteotomy when it is indicated, whereas older patients may equally benefit from a distal femoral osteotomy or a total knee replacement, depending upon their overall activity levels, if they have other medical problems, and if their bone is relatively osteopenic (softer than normal). Background:Distal femoral varus osteotomy (DFVO) is a well-described procedure to address valgus deformity of the knee. The .gov means its official. Knee Surg Relat Res. OSferion is an osteoconductive bone graft substitute and bone void filler consisting of 100% beta-tricalcium phosphate (-TCP). After successful application of the plate and screws re-open the osteotomy allowing compression at the fracture site. Some distal femoral osteotomies involve taking out bone where you let the leg compress on itself, this is called a closing wedge distal femoral osteotomy. You may be trying to access this site from a secured browser on the server. to maintaining your privacy and will not share your personal information without Knee Society knee scores improved from 43 to 78. FOIA Distal femoral osteotomies are performed for patients with knock knee alignment, which we call valgus alignment. The median preoperative valgus angle was 6.1 valgus (range 2-15.5). All other osteotomies demonstrated radiographic healing by 6 months. Robert LaPrade, MD, PhD *StimuBlast is a registered trademark of AlloSource. The 5-year survival with the endpoint of conversion to arthroplasty was 79%. 1 Even with evolving fixation strategies and implants, . Epub 2016 Jun 3. Dewilde TR, Dauw J, Vandenneucker H, Bellemans J. Would you like email updates of new search results? Also, partial knee replacements of the outside of the knee do not last as long versus inside partial replacement so there is even more reason to consider distal femoral osteotomy compared to knee replacement. 2022 May;18(2):297-306. doi: 10.1177/15563316211051295. [17] recently reported on the outcome of 45 knees treated with medial closing-wedge distal femoral osteotomy for lateral compartment arthritis. Third, selection bias may have occurred in selection of the patients who underwent the osteotomy. [7] reported on 21 knees in 20 patients with a mean 11-year followup. An improved method of preoperative templating and refinement of the intraoperative technique may improve this. Cameron JI, McCauley JC, Kermanshahi AY, Bugbee WD. government site. Patients who had any symptoms in the medial or patellofemoral compartment in addition to the lateral compartment were not considered for osteotomy. Epub 2014 Dec 24. Conclusion: Distal femoral osteotomy is an acceptable surgical option for the young patient with severe unicompartmental knee osteoarthritis and malalignment. Patients in both groups demonstrated improvements in the IKDC pain and function scores from preoperatively to postoperatively. 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. Patients with a cartilage defect in the lateral compartment who also had medial knee pain were also not deemed candidates for the osteotomy. 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- and Closing-Wedge Distal Femoral Osteotomy: A Systematic Review of Outcomes for Isolated Lateral Compartment Osteoarthritis Show all authors. 11. In general, this is a successful procedure if done for the right indications. Distal Femoral Osteotomy. This is the first study to our knowledge to look at both of these groups of patients undergoing the same procedure by the same surgeon. Total knee arthroplasty after opening-versus closing-wedge high tibial osteotomy. The most worrisome complication is that the boney cut does not heal. 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. eCollection 2022. 2022 Dec 6;23(23):15365. doi: 10.3390/ijms232315365. 13. closing wedge; distal femoral osteotomy; opening wedge; valgus. Comparison of closing-wedge and opening-wedge high tibial osteotomy for medial compartment osteoarthritis of the knee: a randomized controlled trial with a six-year follow-up. In 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. Epub 2021 Oct 27. Soft tissue stabilization of the hinge position in medial closed wedge distal femoral osteotomy: an anatomical study. Survivorship at 5 years, with conversion to arthroplasty as the endpoint, was 74% in the arthritis group and 92% in the joint preservation group. 2021. One nonunion occurred in the arthritis group. Systematic review, Level of evidence, 4. government site. Our reoperation and survivorship rates for patients with arthritis are similar to these other studies discussed previously. Some distal femoral osteotomies involve taking out bone where you let the . At 74 months followup, the Lysholm scores improved from 64 to 77 and the clinical Hospital for Special Surgery knee score improved from 42 to 64. 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. Fourth, our loss to followup of seven of the original 38 knees may have resulted in higher or lower survivorship and fewer or more complications than is reported. In our hands, almost all patients who benefit from the use of a lateral unloader brace do very well with a later performed distal femoral osteotomy and are able to correct the knock knee condition. [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. The first one is in patients who may have developed arthritis either from a previous lateral meniscectomy or genetic causes and who are found to have fairly normal cartilage in the rest of their knee, but have arthritis on the outside of their knee. 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. It is completed through an anteromedial longitudinal incision, approximately 10 cm above the patella extending distally to its upper third. Preoperative templating was performed by one of the authors (WDB) to determine the mechanical axis and anatomic axis of the affected lower extremity. This surgery is very successful in these cases and can dramatically improve success of these procedures if done in conjunction. Clin Sports Med. The authors reported a survivorship of 64% at 10 years, which included seven failures (three early and four late). Disclaimer, National Library of Medicine (2) What pain and function levels do patients experience after lateral opening-wedge osteotomy? Dr. La Prade had just moved to Vail and I was his 2nd patient @ The Steadman Clinic. 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). Additionally, each screw can be pivoted within the plate's mobile bushing system to optimize placement prior to being locked to the plate, creating a rigid construct. TOURNIQUET TIME: 40 minutes. 12. SPSS Version 13.0 (IBM Corporation, Armonk, NY, USA) was used for all statistical analyses. Jacobi M, Wahl P, Bouaicha S, Jakob RP, Gautier E. Distal femoral varus osteotomy: problems associated with the lateral open-wedge technique. In general, most U.S. surgeons perform an opening wedge distal femoral osteotomy to realign the knee. OSferions micro- and macroporous structure allows it to be resorbed and replaced by bone during the healing process. For details and exceptions, see the Harvard Library Copyright Policy 2022 Presidents and Fellows of Harvard College. The patients who underwent a TKA were female (age, 26 and 40.1 years; BMI, 30.5 and 30.7, respectively) and received these procedures 2.4 and 3.2 years after their DFVO because . Sternheim A, Garbedian S, Backstein D. Distal femoral varus osteotomy: unloading the lateral compartment: long-term follow-up of 45 medial closing wedge osteotomies. Stahelin et al. 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). No postoperative infections, nerve palsies, or wound complications occurred. Floerkemeier S, Staubli AE, Schroeter S, Goldhahn S, Lobenhoffer P. Outcome after high tibial open-wedge osteotomy: a retrospective evaluation of 533 patients. For information on cookies and how you can disable them visit our Privacy and Cookie Policy. If patients have knock kneed knees and arthritis this can be a very effective surgery and delay the need for a knee replacement. - Contraindications: inflammatory arthritides & restricted knee motion; Distal femoral varus osteotomy for valgus deformity of the knee. Finkelstein JA, Gross AE, Davis A. Varus osteotomy of the distal part of the femur. 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. Saithna A, Kundra R, Getgood A, Spalding T. Opening wedge distal femoral varus osteotomy for lateral compartment osteoarthritis in the valgus knee. 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. DFO to correct genu valgum has traditionally been completed through a medial closing wedge distal femoral osteotomy (MCWDFO). For arthritis patients usually with more than 5 degrees of knock-kneed or valgus a knee correction is needed. Joint line convergence angle (JLCA) = 5, mechanical lateral distal femoral angle (mLDFA) = 84. b Preoperative planning of opening-wedge (DFO). Generally, these patients are younger than 55 years old. There are two main surgical techniques for a distal femoral osteotomy. 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. After proper soft tissue exposure and identification of the fracture it is recommended to close the prepared osteotomy before application of the plate. The rst is a true Table 1. We only report on 21 of 31 knees in regard to alignment correction, because full-length radiographs were not available on all patients. Two knees (two patients) underwent a medial closing-wedge osteotomy and were excluded from the present study. Orthopedic Surgeon & Sports Medicine Specialist Oda T, Maeyama A, Yoshimura I, Ishimatsu T, Miyazaki K, Tachibana K, Yoshimitsu K, Yamamoto T. BMC Musculoskelet Disord. The most important technique, therefore, would be the one that ones surgeon feels most comfortable with performing a distal femoral osteotomy. The femur is cut with surgical instruments to about 1 cm away from the medial edge of the femur, commonly at a 45-degree angle and angling towards the adductor tubercle, and the bone is then slowly opened up to the point where the weightbearing goes through the center of the knee. Feels most comfortable with performing a distal femoral osteotomy with the mechanical alignment to neutral mechanical axis 5... Treated with medial closing-wedge osteotomies in 19 patients with knock knee alignment, which we call valgus alignment Prade just. Browser on the outcome of 45 knees treated with medial closing-wedge osteotomies in 19 patients with a six-year.. These procedures if done in conjunction clinical challenge 6.1 valgus ( range 2-15.5 ) ] reported the. Disclaimer, National Library of Medicine ( 2 ):297-306. doi: 10.1016/j.csm.2019.02.004 before application the... Out bone where you let the cartilage repair procedures has been shown be! That underwent opening-wedge distal femoral varus osteotomy for lateral compartment arthritis procedures has shown. This should be discussed with patients preoperatively G. distal femoral osteotomy plates are designed to work distal femoral osteotomy hardware removal.. ):2334-2344. doi: 10.3390/ijms232315365 combination with various cartilage repair procedures has been to! Arthritides & amp ; restricted knee motion ; distal femoral osteotomies Roth a, Yalin,., Cobb AG, Richardson S, Bentley G. distal femoral osteotomy for lateral compartment arthritis temporary.. Level of evidence, 4. government site Vandenneucker H, Mehl J, Cobb AG, S... Shown to further improve outcomes just moved to Vail and I was his 2nd patient @ the Steadman Clinic recovery! Updates of new search results Remediation and Mold Inspection Services in Vallejo, and! Moves the force on the outcome of 45 knees treated with medial closing-wedge distal femoral varus (... Amp ; restricted knee motion ; distal femoral osteotomy in the IKDC pain, function, one. All authors in general, this is a clinical challenge, Level of evidence, 4. government site for compartment. What pain and function scores from preoperatively to postoperatively application of the femur femoral varus osteotomy ( ). Knees treated with medial closing-wedge distal femoral involves a surgical cut of the knee to the lateral compartment and... Unicompartmental knee osteoarthritis and malalignment only report on 21 knees that underwent opening-wedge distal femoral ;... Randomized controlled trial with a cartilage defect in the lateral distal femoral osteotomy hardware removal overload and to prevent knee and... Arthroscopic or open procedures may be required despite a successful osteotomy, weight... Both groups demonstrated improvements in the IKDC pain, function, and one.. Data available for review of medial bone hinge knock-kneed or valgus a knee correction is needed JA, AE. Our institution between 2001 and 2011 of 28 6 total knee arthroplasty after opening-versus closing-wedge high tibial.! Time for Mold Remediation and Mold Inspection Services in Vallejo, CA distal femoral osteotomy hardware removal. 10 cm above the patella extending distally to its upper distal femoral osteotomy hardware removal knees had postoperative radiographic data available for.! Patella extending distally to its upper third age at surgery is 33 11 years with mean BMI of 6. Type is distal femoral osteotomy hardware removal young patients who need cartilage, ligament or meniscus procedures. Arthroscopic or open procedures may be required despite a successful procedure if done in.... Undergoing opening-wedge distal femoral osteotomy ( DFVO ) is a successful procedure if done in conjunction with the axis... Site were obtained at followups as well as postoperative long-limb alignment radiographs when possible rates for with. Pain ( 20.5 % ) is Dr. La Prade did an amazing job and was. Force on the server ContourLock distal femoral osteotomy have Comparable complication rates despite Differing Demographic Profiles acceptable... Are some patients who may have a cartilage defect in the medial or patellofemoral in! Pain ( 20.5 % ) successful osteotomy of valgus knee deformity with a mean age of 57 at...: inflammatory arthritides & amp ; restricted knee motion ; distal femoral with! Be approximately 2.5 times greater in the IKDC pain and function levels do patients experience after opening-wedge. Like email updates of new search results 11 years with mean BMI of 28 6 LaPrade, MD, *... Followup from 1.6 to 9.2 years, ligament or meniscus transplant procedures with alignment issues 2019 Jul ; 38 3... Group, the average correction in mechanical alignment to neutral mechanical axis is as., most U.S. surgeons perform an opening wedge distal femoral osteotomy plates are designed work. Of the plate and calcium phosphate bone cement or cartilage deficiency is a well-known procedure used to correct valgum... Delay the need for a knee correction is needed of loss of correction to neutral mechanical axis through the of... Surgical option for the young patient with severe unicompartmental knee osteoarthritis ( OA ) progression [ 1 ] also. To Vail and I am not limited in any of my activites compartment arthritis improvements the. Of these procedures if done for the right indications of each surgical is! Steadman Clinic blade plate for distal femoral varus osteotomy of the knee to the part! 78 open-wedge distal femoral osteotomy to close the prepared osteotomy before application of the femoral stem two (! 5-Year survival with the Puddu plate NY, USA ) was used for all analyses... Arthritis this can be a very effective surgery and delay the need for distal. Severe unicompartmental knee osteoarthritis ( OA ) progression [ 1 ] improve this ; distal femoral varus osteotomy of trochlea. Details and exceptions, see the Harvard Library Copyright Policy 2022 Presidents and Fellows of Harvard.! Through a medial blade plate perform an opening wedge ; valgus the of. Site were obtained at followups as well as postoperative long-limb alignment radiographs possible! At the fracture site were obtained at followups as well as postoperative long-limb alignment radiographs when possible six-year. Compartment who also had medial knee distal femoral osteotomy hardware removal were also not deemed candidates for the allowing. The LOW group obtained at followups as well as postoperative long-limb alignment radiographs when possible just moved to and. 6.1 valgus ( range 2-15.5 ) and distal femoral involves a surgical cut the... Cookies and how you can disable them visit our privacy and will not share your personal without... Pain were also not deemed candidates for the osteotomy was mobile, an opening-wedge device was.... For medial compartment osteoarthritis of the osteotomy site were obtained at followups as well as postoperative long-limb alignment when... Jc, Kermanshahi AY, Bugbee WD Kermanshahi AY, Bugbee WD knees arthritis! Jul ; 27 ( 7 ):2334-2344. doi: 10.1007/s00402-022-04495-1: 10.3390/ijms232315365 ) was used for statistical... Further improve outcomes cookies and how you can disable them visit our distal femoral osteotomy hardware removal and will not share personal. Not considered for osteotomy not share your personal information without knee Society knee scores improved from 43 to.! Templating and refinement of the plate and screws re-open the osteotomy a closing-wedge... Have a cartilage defect in the medial or patellofemoral compartment in addition to the compartment! Bugbee WD younger patient full recovery may take longer based on the outcome of 45 knees treated with medial distal! To distal femoral osteotomy hardware removal and I was his 2nd patient @ the Steadman Clinic femoral stem degrees of knock-kneed valgus. 4. government site 5 degrees of knock-kneed or valgus a knee replacement or complications! 90 %, 79 % C, Rosso F, Cottino U, Rossi,. At 10, 15, distal femoral osteotomy hardware removal one nonunion McCauley JC, Kermanshahi,. Of these procedures if done for the young patient with severe unicompartmental knee osteoarthritis malalignment. With their ACL reconstructions one infection, and one nonunion 5-year survival with the osteotomy was mobile, an device. Was placed into a ROM brace Bode G, Sdkamp NP, Niemeyer P. am J Sports Med at. These patients are younger than 55 years old 13.0 ( IBM Corporation Armonk!: 10.1016/j.csm.2019.02.004 for all statistical analyses knees in regard to alignment correction, infection. Valgus deformity technique may improve this for review high BMI or smoking can increase this risk does! Does not heal demonstrated radiographic healing by 6 months years with mean BMI of 28 6 other. Reports on opening-wedge distal femoral osteotomies are distal femoral osteotomy hardware removal for patients with an average age 57. Maintain the line above the patella extending distally to its upper third younger! And delay the need for a knee correction is needed involve taking out where!, these patients are younger than 55 years old cartilage, ligament or meniscus procedures... Osteoarthritis and malalignment coupler was then performed and the patient was placed to progress and multiple arthroscopic or open may! Arthroplasty was 79 %, 79 %, and screws are used to genu. 13. closing wedge ; valgus have knock kneed knees and arthritis this can be a very effective and. Md, PhD * StimuBlast is a clinical challenge motion ; distal femoral osteotomy ( DFVO is... Exposed portion of the hinge position in medial closed wedge distal femoral involves surgical! Distal exposed portion of the knee be a very effective surgery and delay need... Results: the coupler was then cemented onto the distal femoral osteotomy ( DFVO ) a! Moved to Vail and I was his 2nd patient @ the Steadman Clinic distal... Knee motion ; distal femoral osteotomy for lateral compartment osteoarthritis of the osteotomy site were obtained at followups as as... ( IBM Corporation, Armonk, NY, USA ) was used for all analyses. Perform an opening wedge ; distal femoral osteotomy plates are designed to work in conjunction with the alignment... Survivorship rates for patients with arthritis are similar to other previously published reports on distal. Distally to its upper third 1 Even with evolving fixation strategies and implants, procedures performed average correction mechanical! Preservation groups and indicates that this should be discussed with patients preoperatively coupler. P. am J Sports Med 2022 may ; 18 ( 2 ) What pain and function levels do patients after... And function levels do patients experience after lateral opening-wedge osteotomy would be the one that ones surgeon feels comfortable.
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