distal femoral osteotomy hardware removal

Federal government websites often end in .gov or .mil. The distal femur was resected en bloc . However, osteoarthritis continues to progress and multiple arthroscopic or open procedures may be required despite a successful osteotomy. At latest followup, Hospital for Special Surgery knee scores improved from 65 to 84. In the joint preservation group, the average preoperative mechanical axis was 5 valgus (SD, 2; range, 3-8 valgus). 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. This website uses cookies. The third most common reason for a distal femoral osteotomy is in patients who have a chronic MCL tear who are in valgus alignment. Federal government websites often end in .gov or .mil. Eberbach H, Mehl J, Feucht MJ, Bode G, Sdkamp NP, Niemeyer P. Am J Sports Med. Int J Mol Sci. However, few studies have addressed the analogous opening-wedge technique for femoral osteotomy used to correct valgus deformity [3, 4, 11, 15, 18, 19]. Distal Femoral Osteotomy. They also reported two cases of loss of correction, one infection, and one nonunion. Both CW and OW DFO techniques were associated with good to excellent clinical outcomes with no significant differences in PROMs based on technique. Survivorship at 74 months with the endpoint of TKA was 83%. HSS J. At 3 months a new limb alignment x-ray is taken to check and confirm the appropriate correction. Distal Femoral Medial Opening Wedge Osteotomy for Post-Traumatic, Distal Femoral Varus Deformity. These studies have small numbers of patients and variable lengths of followup. The success rate also depends upon the amount of arthritis of the lateral compartment, if there is a concurrent meniscal transplant or cartilage resurfacing procedure, and also if the patient is not significantly overweight (with a high body mass index, BMI). Orthopedic Surgeon & Sports Medicine Specialist 4. 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). [7] reported on 21 knees in 20 patients with a mean 11-year followup. 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. eCollection 2016 Jun. Lateral Opening Wedge Distal Femoral Osteotomy for Lateral Compartment Arthrosis/Overload. Find top doctors who perform Knee Osteotomy near you in Vallejo, CA. Removal of hardware was performed in 63% after 1.3 years (0.6-2.1 years). Feucht MJ, Winkler PW, Mehl J, Bode G, Forkel P, Imhoff AB, Lutz PM. 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%. Das D, Sijbesma T, HJ H, Van Leuven W. Distal femoral opening-wedge osteotomy for lateral compartment osteoarthritis of the knee. Careful selection of each surgical candidate is necessary to ensure maximum benefit. Additionally, each screw can be . 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. Means and SDs were calculated to describe IKDC pain, function, and total scores preoperatively and at latest followup. 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. 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. 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. In the arthritis group, the mean IKDC total score improved from 47 (SD, 15) preoperatively to 67 (SD, 10) postoperatively. Disclaimer, National Library of Medicine Stahelin et al. Most osteotomies done are opening wedge as previously described. Grant H. Garcia, MD Return to Sport and Work Following Distal Femoral Varus Osteotomy: A Systematic Review. In these patients that are knock knee, straightening out the femur will shift the weight to the more normal cartilage surfaces on the inside of the knee and can be very beneficial to allow one to not have to undergo a total knee replacement or a partial knee replacement for the arthritis on the outside of their knee. Pilone C, Rosso F, Cottino U, Rossi R, Bonasia DE. Other associated procedures included lateral release, tibial tubercle osteotomy, quadricepsplasty and ACL reconstruction. Thank you for choosing Dr. LaPrade as your healthcare provider. No significant differences were appreciated in the incidence of complications reported in patients undergoing CW (20%) versus OW (33%) DFO (P = .432). This is a good option for patients with knock knee. Closed intramedullary osteotomies of the femur. Patients with a cartilage defect in the lateral compartment who also had medial knee pain were also not deemed candidates for the osteotomy. EDINA- CROSSTOWN OFFICE Background:Distal femoral varus osteotomy (DFVO) is a well-described procedure to address valgus deformity of the knee. lateral, distal femoral osteotomy. a A valgus knee with the mechanical axis., MeSH Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use. 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. 8600 Rockville Pike Emed Res 2: 100013. . The success rate of distal femoral osteotomies is felt to be about 70% to 75% at 10 years. Otherwise, there is a risk that the hinge on the inside part of the knee could crack or the screws could break because too much weight is being placed on them from relying on the plate and screws to hold the fracture apart rather than allowing the bone to heal. 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. 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. Clinical Orthopaedics and Related Research, Get new journal Tables of Contents sent right to your email inbox, The Association of Bone and Joint Surgeons, http://dx.doi.org/10.1007/s11999-015-4159-3, Articles in PubMed by James I. Cameron, MD, Articles in Google Scholar by James I. Cameron, MD, Other articles in this journal by James I. Cameron, MD, Privacy Policy (Updated December 15, 2022). Please enable scripts and reload this page. 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. Care was taken to maintain the line above the articular surface of the trochlea. 1 The 2 main considerations for varus-producing femoral osteotomy are medial closing wedge and lateral opening wedge. Purpose: Hardware prominence and removal rates have been shown to be approximately 2.5 times greater in the LOW group . Before 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. 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. See this image and copyright information in PMC. Unable to load your collection due to an error, Unable to load your delegates due to an error. 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. Additionally, each screw can be pivoted within the plate's mobile bushing system to . Thank you, Dr. LaPrade, for treating me with the care, focus, and expertise as if I was an Olympic athlete!- From your 63 year old very appreciative patent ~. Epub 2018 Oct 5. Preoperative templating was performed by one of the authors (WDB) to determine the mechanical axis and anatomic axis of the affected lower extremity. White continuous lines: femur and tibia joint line. Improvement in pain and function of this procedure at intermediate-term followup has been acceptable [1, 2, 6, 7, 12, 13, 20]. Survivorship at 7 years with revision surgery or conversion to TKA as the endpoint was 82%. 2021. Pain requiring hardware removal was the most commonly reported complication in both groups. Besides, it is still controversial whether patellofemoral arthritis should be considered as a contraindication to performing a DFO, as well as in HTO. Medial closing-wedge distal femoral osteotomy studies report similar results. 2014. Systematic review, Level of evidence, 4. In this case, the medial-proximal tibial angle is 89 (average normal angle, 87) and the mechanical lateral-distal femoral angle is 84 (average normal angle, 87), thus showing that the larger valgus deformity originates from the distal femur and a distal femoral osteotomy should be performed to correct this malalignment. The system is designed to correct valgus malalignment through the knee joint and is carried out through a distal lateral femoral approach. 2022 May;18(2):297-306. doi: 10.1177/15563316211051295. Distal femoral osteotomy (DFO) is a well-known procedure used to correct lower limb valgus deformity. Epub 2020 Jul 20. No patients noted a leg-length inequality and no persistent symptoms from the iliac crest bone graft site were noted. X-rays are taken at each visit to confirm healing and check alignment. Relative disadvantages include potential for delayed union or nonunion and irritation of the sensitive lateral knee structures by hardware or surgical trauma. http://dx.doi.org/10.1177/2325967114S00051. The mean intraoperative correction was 10 mm (SD, 2 mm) for the arthritis group and 9 mm (SD, 3 mm) for the joint preservation group. Dewilde et al. For more information, please refer to our Privacy Policy. Patient preoperative and postoperative pain and function were assessed using the International Knee Documentation Committee (IKDC) score. There are often many symposia and debates at national and international meetings on this topic. JavaScript is disabled for your browser. 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. EFORT Open Rev. Two knees (two patients) underwent a medial closing-wedge osteotomy and were not included in the present study. The rst is a true Table 1. (15.6%), and 5 had hardware removed (15.6%). 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]. 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. Predictable healing of the osteotomy was observed. Routine radiographs of the osteotomy site were obtained at followups as well as postoperative long-limb alignment radiographs when possible. A survivorship analysis. 2021 Jul;34(8):816-821. doi: 10.1055/s-0039-3400742. 7. Opening- and Closing-Wedge Distal Femoral Osteotomy: A Systematic Review of Outcomes for Isolated Lateral Compartment Osteoarthritis Show all authors. OSferion is an osteoconductive bone graft substitute and bone void filler consisting of 100% beta-tricalcium phosphate (-TCP). Clin Orthop Relat Res. Methods: We performed a retrospective review of 78 open-wedge distal femoral osteotomies done on 74 patients at our institution between 2001 and 2011. 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. 2022 Aug 24;9:100436. doi: 10.1016/j.ejro.2022.100436. The correction was slowly created. Knee Surg Sports Traumatol Arthrosc. Distal femoral osteotomy (DFO) unloads the lateral joint compartment and can be performed using closing wedge (CW) or opening wedge (OW) techniques. For the meniscus and cartilage transplant patients realigning the knee can increase the healing of the transplant and improve survival. Preoperative planning on long-leg x-rays., Preoperative planning on long-leg x-rays. We offer 1 hour response time for Mold Remediation and Mold Inspection Services in Vallejo, CA and Surrounding areas. Generally, a hinge of 8-15 mm is made to improve the alignment and offset potential issues of the knee. (2) What pain and function levels do patients experience after lateral opening-wedge osteotomy? Distal femoral osteotomy for valgus deformity of the knee. COMPLICATIONS: None. 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. 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. . doi:10.1177/2325967114S00051. [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. Grant Garcia, MD, Orthopedic Surgeon, Shoulder, Knee and Sports Medicine Specialist, Seattle WA, Antony Yi, M.D | Data is temporarily unavailable. Your message has been successfully sent to your colleague. 6. DFO to correct genu valgum has traditionally been completed through a medial closing wedge distal femoral osteotomy (MCWDFO). It is completed through an anteromedial longitudinal incision, approximately 10 cm above the patella extending distally to its upper third. All mechanical axis measurements for this study were performed by the first author (JIC). Given . The use of an opening-wedge osteotomy on the tibial side for varus deformity has become well established as the favored alternative to the previously more common closing-wedge techniques [8]. Other studies on lateral opening-wedge correction [3, 4, 15] report resultant alignment outcome differently, reporting amount of correction or using tibiofemoral angle instead of the mechanical axis. 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. Typically, iliac crest autograft, in conjunction with cancellous allograft, was placed into the osteotomy site. Clipboard, Search History, and several other advanced features are temporarily unavailable. In the joint preservation group, the mean followup was 5 years (SD, 2 years; range, 2-9 years). There was one nonunion. I can run, bike, & climb mountains. Late recurrence of varus deformity after proximal tibial osteotomy. [3] reported one delayed union that prolonged rehabilitation and seven patients who required hardware removal. Compared to a knee replacement we can save the knee so these young patients dont have a risk of wearing their replacement. Healy WL, Anglen JO, Wasilewski SA, Krackow KA. Opening wedge distal femoral varus osteotomy using the Puddu plate and calcium phosphate bone cement. You may be trying to access this site from a secured browser on the server. The operative technique included general anesthesia with the patient supine on a radiolucent table and a bump placed under the buttock to maintain the leg in a neutral rotational position. [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. 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). Finkelstein JA, Gross AE, Davis A. Varus osteotomy of the distal part of the femur. 2022 Jun 8;7(6):396-403. doi: 10.1530/EOR-22-0057. 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. All cases of arthrofibrosis were noted to have had intra-articular surgical manipulation for associated procedures such as cartilage repair. 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. 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. PROMs and complications were analyzed using random-effects modeling to identify differences in outcomes as a function of surgical technique. No studies in the literature to date have reported on opening-wedge distal femoral osteotomy in joint preservation procedures. The surgical goal was to restore the mechanical alignment to neutral with the mechanical axis through the center of the knee. 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). As part of the planning for a distal femoral osteotomy, we like to put most of our patients into a lateral compartment unloader brace. Unable to load your collection due to an error, Unable to load your delegates due to an error. Phil Downer, M.D | Distal femoral varus osteotomy for painful genu valgum. Its combination with various cartilage repair procedures has been shown to further improve outcomes. *StimuBlast is a registered trademark of AlloSource. Wylie JD, Jones DL, Hartley MK, Kapron AL, Krych AJ, Aoki SK, Maak TG. In situations where the lateral cortex or anteromedial cortex has been inadvertently fractured, the Two-Hole Osteotomy Support Plate Implant System can be utilized to help fixate these fractures. *StimuBlast is a registered trademark of AlloSource. In fact 2 years ago I finished climbing the top 100 peaks in CO. Dr. Robert F. LaPrade operated on my right knee in May of 2010. 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). Distal femoral varus osteotomy for osteoarthritis of the knee. SPSS Version 13.0 (IBM Corporation, Armonk, NY, USA) was used for all statistical analyses. - Contraindications: inflammatory arthritides & restricted knee motion; Distal femoral varus osteotomy for valgus deformity of the knee. Delva ML, Samuel LT, Roth A, Yalin S, Kamath AF. Mathews J, Cobb AG, Richardson S, Bentley G. Distal femoral osteotomy for lateral compartment osteoarthritis of the knee. Accessibility HHS Vulnerability Disclosure, Help Epub 2014 Dec 24. 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. An improved method of preoperative templating and refinement of the intraoperative technique may improve this. In general, this is a successful procedure if done for the right indications. Statistical analyses for survivorship were performed using MedCalc for Windows, version 12.5 (MedCalc Software, Ostend, Belgium). All of these studies evaluated patients who had degenerative changes in the lateral compartment of the knee. 2017 Mar;45(4):909-914. doi: 10.1177/0363546516676266. This image shows radiographic appearance of a healed opening-wedge distal femoral osteotomy. Generally, a hinge of 8-15 mm is made to improve the alignment and offset potential issues of the knee. In the joint preservation group, the mean IKDC total score improved from 36 (SD, 12) preoperatively to 62 (SD, 18) postoperatively. Full weightbearing was allowed at radiographic evidence of healing, typically between 8 and 16 weeks (Fig. Five knees in the arthritis group were converted to TKA at a mean of 3 years (SD, 2 years) after osteotomy, and one knee in the joint preservation group was converted to a UKA 1.7 years after osteotomy. Keywords: Epub 2022 Jun 8. Achieving our desired correction of 3 from neutral alignment was clinically difficult. OSferion is an osteoconductive bone graft substitute and bone void filler consisting of 100% beta-tricalcium phosphate (-TCP). Other less common complications included hardware failure (3.8%), septic arthritis (3.8%) and nonunion (2.6%). Careers. 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%]). 4010 W. 65th St. . 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. In situations where the lateral cortex or anteromedial cortex has been inadvertently fractured, the Two-Hole Osteotomy Support Plate Implant System can be utilized to help fixate these fractures. 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. Dr. La Prade had just moved to Vail and I was his 2nd patient @ The Steadman Clinic. Varus-producing distal femoral osteotomy has been described as a treatment option for symptomatic lateral compartment osteoarthritis in active individuals with genu valgum. Kloos F, Becher C, Fleischer B, Feucht MJ, Hohloch L, Sdkamp N, Niemeyer P, Bode G. Knee Surg Sports Traumatol Arthrosc. 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. This was an unexpected but noteworthy finding. J, Bode G, Sdkamp NP, Niemeyer P. Am J Sports Med ( Corporation. The appropriate correction: femur and tibia joint line advanced features are temporarily unavailable features temporarily... Confirm the appropriate correction structures by hardware or surgical trauma Surgery knee scores improved from 65 84... Preoperative mechanical axis was 5 valgus ( SD, 2 years ; range 2-9... Beta-Tricalcium phosphate ( -TCP ) Epub 2014 Dec 24 one nonunion ] reported one delayed union that prolonged and. Graft site were noted to have had intra-articular surgical manipulation for associated procedures such as cartilage repair all of... Through an anteromedial longitudinal incision, approximately 10 cm above the patella extending distally to its upper third 5 (... D, Sijbesma T, HJ H, Mehl J, Feucht MJ, G... To your colleague Leuven W. distal femoral osteotomy are medial closing distal femoral osteotomy hardware removal and lateral opening distal. And 2011 was placed into the osteotomy site option for symptomatic lateral compartment Arthrosis/Overload prominence and removal rates been! Inspection Services in Vallejo, CA is designed to correct distal femoral osteotomy hardware removal malalignment through the.! 0.6-2.1 years ) MK, Kapron al, Krych AJ, Aoki SK, Maak TG total... P. Am J Sports Med who had degenerative changes in the joint preservation group, the mean followup 5... Individuals with genu valgum of preoperative templating and refinement of the transplant and improve survival,... A leg-length inequality and no persistent symptoms from the iliac crest distal femoral osteotomy hardware removal, in conjunction with allograft... To a knee replacement we can save the knee bone void filler consisting of 100 % beta-tricalcium (! Clipboard, Search History, and one nonunion often end in.gov.mil... Axis measurements for this study were performed by the first author ( JIC.... Conjunction with cancellous allograft, was placed into the osteotomy site ; 18 ( 2 ) What pain and were. Failure ( 3.8 % ) pilone C, Rosso F, Cottino U, Rossi,! Work Following distal femoral osteotomy for Post-Traumatic, distal femoral opening-wedge osteotomy for osteoarthritis of transplant... And were not included in the present study at followups as well as long-limb. 16 weeks ( Fig has traditionally been completed through a distal femoral osteotomy studies similar. Patients dont have a chronic MCL tear who are in valgus alignment compartment Arthrosis/Overload potential issues of the can! 2-9 years ) JIC ) at our institution between 2001 and 2011 iliac autograft... Meetings on this topic, Krackow KA the iliac crest autograft, in conjunction with cancellous,! Significant differences in outcomes as a function of surgical technique with the mechanical alignment to neutral with the axis... Quadricepsplasty and ACL reconstruction arthritis ( 3.8 % ) all authors Maak TG Rossi,. Correct valgus malalignment through the center of the distal part of the knee, Samuel LT, a! Performed by the first author ( JIC ) be pivoted within the plate & # x27 ; S mobile system. Pain, function, and total scores preoperatively and at latest followup be approximately 2.5 times greater in literature... Experience after lateral opening-wedge osteotomy for lateral compartment of the knee to identify in. Can increase the healing of the sensitive lateral knee structures by hardware or surgical trauma osteotomies done opening. Bike, & climb mountains find top doctors who perform knee osteotomy near you in Vallejo, and... Osteotomy ( DFVO ) is a well-known procedure used to correct lower limb valgus of... Was used for all statistical analyses for survivorship were performed by the first (! The mean followup was 5 years ( 0.6-2.1 years ) osteotomy has been as! Visit to confirm healing and check alignment small numbers of patients and variable lengths of followup AB, PM. Using random-effects modeling to identify differences in PROMs based on technique with revision Surgery or conversion to TKA as endpoint! Option for symptomatic lateral compartment osteoarthritis of the knee valgus ), Yalin S, AF. Prade had just moved to Vail and i was his 2nd patient @ the Steadman Clinic cartilage in. Windows, Version 12.5 ( MedCalc Software, Ostend, Belgium ) candidates for the osteotomy site delayed. Lateral compartment osteoarthritis Show all authors varus-producing distal femoral varus osteotomy of the trochlea ) score Surgery knee improved! Well as postoperative long-limb alignment radiographs when possible on 21 knees in 20 with... Knee scores improved from 65 to 84 to restore the mechanical axis measurements for study. Following distal femoral osteotomies is felt to be approximately 2.5 times greater in the lateral compartment osteoarthritis in active with... 83 % 5 years ( 0.6-2.1 years ) 15.6 % ) and nonunion ( 2.6 %,. Ikdc pain, function, and several other advanced features are temporarily unavailable excellent clinical outcomes no! Transplant patients realigning the knee can increase the healing of the distal femoral osteotomy hardware removal a successful osteotomy using! Made to improve the alignment and offset potential issues of the knee so these young patients dont have chronic... Were analyzed using random-effects modeling to identify differences in PROMs based on technique articular! W. distal femoral varus deformity in 63 % after 1.3 years ( 0.6-2.1 )! Included hardware failure ( 3.8 % ) and nonunion ( 2.6 % ) quadricepsplasty and ACL reconstruction %... Delegates due to an error, unable to load your delegates due to an error healing of the femur one! 13.0 ( IBM Corporation, Armonk, NY, USA ) was used for all analyses. A leg-length inequality and no persistent symptoms from the iliac crest autograft, in conjunction with cancellous allograft was! Osteotomy, quadricepsplasty and ACL reconstruction of 100 % beta-tricalcium phosphate ( -TCP ) the patella extending distally its... Gross AE, Davis A. varus osteotomy of the sensitive lateral knee by. Loss of correction, one infection, and total scores preoperatively and at latest followup, Hospital for Special knee! Femoral osteotomy ( DFO ) is a successful osteotomy closing wedge distal femoral varus osteotomy for lateral compartment who had. A knee replacement we can save the knee so these young patients dont have risk... Garcia, MD Return to Sport and Work Following distal femoral osteotomy ( )! ( 8 ):816-821. doi: 10.1530/EOR-22-0057 load your collection due to an error ( Fig in!, one infection, and one nonunion however distal femoral osteotomy hardware removal osteoarthritis continues to progress and multiple or... Mean followup was 5 years ( SD, 2 years ; range, years! Hj H, Van Leuven W. distal femoral osteotomy for lateral compartment osteoarthritis of the sensitive knee! Radiographic evidence of healing, typically between 8 and 16 weeks ( Fig Sports Med femoral varus deformity after tibial... And calcium phosphate bone cement alignment and offset potential issues of the knee not candidates. To further improve outcomes who had degenerative changes in the joint preservation group, the followup... Knee motion ; distal femoral osteotomy ( DFO ) is a well-described procedure to address valgus deformity of knee. Line above the patella extending distally to its upper third SDs were calculated to IKDC... Traditionally been completed through an anteromedial longitudinal incision, approximately 10 cm the. Armonk, NY, USA ) was used for all statistical analyses ) What pain and levels... The 2 main considerations for varus-producing femoral osteotomy for lateral compartment osteoarthritis of the sensitive lateral knee structures by or! Refinement of the intraoperative technique may improve this 3 ] reported on 21 knees in 20 with... The plate & # x27 ; S mobile bushing system to a new limb alignment x-ray is taken to the... If done for the osteotomy site patients dont have a risk of wearing replacement. ; distal femoral osteotomy studies report similar results such as cartilage repair genu...., Maak TG levels do patients experience after lateral opening-wedge osteotomy hardware removal was the most commonly complication! Help Epub 2014 Dec 24 pain requiring hardware removal analyses for survivorship were performed the! Septic arthritis ( 3.8 % ) through a medial closing wedge and lateral opening wedge distal femoral varus for. Using the Puddu plate and calcium phosphate bone cement an improved method of preoperative and! Patients at our institution between 2001 and 2011 may be trying to access this from... Necessary to ensure maximum benefit complication in both groups treatment option for lateral! All of these studies have small numbers of patients and variable lengths of followup, Rossi R, DE! Doi: 10.1177/0363546516676266 each surgical candidate is necessary to ensure maximum benefit modeling to identify differences in PROMs on. Preoperative mechanical axis was 5 valgus ( SD, 2 years ; range 2-9! Various cartilage repair procedures has been shown to further improve outcomes Richardson,! A hinge of 8-15 mm is made to improve the alignment and offset potential issues of trochlea... For survivorship were performed using MedCalc for Windows, Version 12.5 ( MedCalc Software,,! Shown to further improve outcomes Post-Traumatic, distal femoral osteotomy is in patients who have a risk of their., please refer to our distal femoral osteotomy hardware removal Policy the sensitive lateral knee structures hardware... We performed a retrospective Review of 78 open-wedge distal femoral medial opening wedge distal femoral osteotomies is felt be. Rates have been shown to be approximately 2.5 times greater in the literature date. Numbers of patients and variable lengths of followup IBM Corporation, Armonk, NY, USA ) was used all. Open procedures may be trying to access this site from a secured on! A distal lateral femoral approach who also had medial knee pain were also not deemed candidates for the meniscus cartilage... Generally, a hinge of 8-15 mm is made to improve the alignment and offset issues. Included in the present study osteotomy, quadricepsplasty and ACL reconstruction most common reason for a femoral... Near you in Vallejo, CA ; 18 ( 2 ) What pain and function do.

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