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. This video shows the surgical technique for a medial opening wedge distal femoral osteotomy, for correcting a knee with valgus deformity (courtesy of Arthrex). Hardware prominence and removal rates have been shown to be approximately 2.5 times greater in the LOW group. 2022 Sep;142(9):2303-2312. doi: 10.1007/s00402-022-04495-1. Additionally, each screw can be . One nonunion occurred in the arthritis group. 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. Opening- and Closing-Wedge Distal Femoral Osteotomy: A Systematic Review of Outcomes for Isolated Lateral Compartment Osteoarthritis. Arthroscopy. 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. Of the 31 knees, 20 (14 in the arthritis group and six in the joint preservation group) had preoperative mechanical axis measurements and 21 (15 in the arthritis group and six in the joint preservation group) had postoperative mechanical axis measurements. sharing sensitive information, make sure youre on a federal Additionally, compared to knee replacement patients are allowed to participate in much more rigorous activities. The correction was slowly created. For more information, please refer to our Privacy Policy. Lower extremity malalignment in association with arthritis or cartilage deficiency is a clinical challenge. Saithna et al. Full weightbearing was allowed at radiographic evidence of healing, typically between 8 and 16 weeks (Fig. HHS Vulnerability Disclosure, Help Accessibility Some error has occurred while processing your request. This realignment moves the force on the arthritis part of the knee to the normal part. 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. your express consent. 11. Preoperatively, the amount of correction was estimated using a simplified calculation of 1 mm of linear correction at the osteotomy site to 1 of correction of axial alignment. No postoperative infections, nerve palsies, or wound complications occurred. 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 . 1. 1). 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. The system is designed to correct valgus malalignment through the knee joint and is carried out through a distal lateral femoral approach. Geometry of the Valgus Knee: Contradicting the Dogma of a Femoral-Based Deformity. Call Us Today (888) 260-0449 Further surgery after lateral opening-wedge distal femoral osteotomy. 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. Wang JW, Hsu CC. 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). SPSS Version 13.0 (IBM Corporation, Armonk, NY, USA) was used for all statistical analyses. eCollection 2022. Most osteotomies done are opening wedge as previously described. Distal femoral varus osteotomy for painful genu valgum. government site. 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. Usually bone graft, plates, and screws are used to hold open the distal femoral osteotomy. If patients have knock kneed knees and arthritis this can be a very effective surgery and delay the need for a knee replacement. For younger patients with ligament and cartilage surgeries the success rate is much high as 90% at 10 years and these procedures in young patients can last upwards of 20 years. 2016 Oct;32(10):2141-2147. doi: 10.1016/j.arthro.2016.04.010. The site is secure. Please enable it to take advantage of the complete set of features! 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 . After proper soft tissue exposure and identification of the fracture it is recommended to close the prepared osteotomy before application of the plate. (3) What are the nonunion, complication, and reoperation rates after lateral opening-wedge osteotomy? Disclaimer, National Library of Medicine Patients who have a distal femoral osteotomy, which is basically a surgical fracture, need to be on crutches until the osteotomy heals sufficiently to start weightbearing. 2022 Dec 19;23(1):1105. doi: 10.1186/s12891-022-06078-y. Thein R, Bronak S, Thein R, Haviv B. Distal femoral osteotomy for valgus arthritic knees. A comment to this article is available at http://dx.doi.org/10.1007/s11999-015-4159-3. Distal femoral osteotomy (DFO) is a well-accepted procedure for the treatment of femoral deformities and associated symptoms including osteoarthritis, especially in younger and physically active patients in whom knee arthroplasty is undesirable. Epub 2016 Jun 3. The most common type of distal femoral osteotomy is one that involves an incision on the outside of the knee. Aglietti P, Menchetti PP. 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. At latest followup, Hospital for Special Surgery knee scores improved from 65 to 84. Future studies with more patients and longer followup will provide clarity on this topic. Robert LaPrade, MD, PhD Time to radiographic union, complications, and reoperations were recorded. 8600 Rockville Pike 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. No significant differences were appreciated in the incidence of complications reported in patients undergoing CW (20%) versus OW (33%) DFO (P = .432). eCollection 2016 Jun. An improved method of preoperative templating and refinement of the intraoperative technique may improve this. Relative disadvantages include potential for delayed union or nonunion and irritation of the sensitive lateral knee structures by hardware or surgical trauma. Second, three different fixation devices were used in the series to secure the osteotomy site and insufficient numbers of patients with each device did not allow analysis of a difference in outcome. Importantly, our survivorship in the joint preservation group was higher than any other reported in the literature to date. While this is very uncommon, putting weight on it before Dr. Garcia instructs you, high BMI or smoking can increase this risk. Varus-producing distal femoral osteotomy has been described as a treatment option for symptomatic lateral compartment osteoarthritis in active individuals with genu valgum. 2. We achieved our goal of within 3 of mechanical neutral alignment in seven of 15 patients in the arthritis group and three of six patients in the joint preservation group who had followup mechanical axis radiographs. distal femoral osteotomy hardware removal. There was one nonunion. Federal government websites often end in .gov or .mil. Distal femoral osteotomy can be technically demanding and various complications are reported in the literature. Limb alignment was checked fluoroscopically and clinically. Eagan, MN 55121, I struggled with my knee for 18 months - having gone from 10,000 steps a day to only walking as needed. government site. Terry GC, Cimino PM. A sterile tourniquet was used. Mathews J, Cobb AG, Richardson S, Bentley G. Distal femoral osteotomy for lateral compartment osteoarthritis of the knee. +1 (617) 495 4089. 2022 Jun 8;7(6):396-403. doi: 10.1530/EOR-22-0057. Additional procedures at the time of lateral opening-wedge distal femoral osteotomy. Chahla J, Mitchell JJ, Liechti DJ, Moatshe G, Menge TJ, Dean CS, LaPrade RF. One nonunion occurred in the arthritis group (3%) and was treated with refixation and grafting (Figs. 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. Matsushita T, Mori A, Watanabe S, Kataoka K, Oka S, Nishida K, Nagai K, Matsumoto T, Hoshino Y, Kuroda R. Arch Orthop Trauma Surg. Phil Downer, M.D | It is completed through an anteromedial longitudinal incision, approximately 10 cm above the patella extending distally to its upper third. sharing sensitive information, make sure youre on a federal In the arthritis group, the mean IKDC total score improved from 47 (SD, 15) preoperatively to 67 (SD, 10) postoperatively. There are two main surgical techniques for a distal femoral osteotomy. Based on these studies, a wide variation exists in the amount of correction as well as the final alignment correction achieved. Our study had several limitations. Das et al. Generally, these patients are younger than 55 years old. An official website of the United States government. 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. Results: Of the 71 patients who followed -up beyond six months post-operatively, seven eventually converted to total knee arthroplasty (9.9%). 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. The calculation of 1 mm of linear correction for 1 of axial correction may be oversimplified. PROMs and complications were analyzed using random-effects modeling to identify differences in outcomes as a function of surgical technique. Two knees (two patients) underwent a medial closing-wedge osteotomy and were not included in the present study. 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. Distal femoral varus osteotomy may be used to treat valgus knee malalignment or to protect a knee compartment in which cartilage restoration surgery (such as osteochondral or meni official website and that any information you provide is encrypted I was hit by a car on my bicycle near Horsetooth Reservoir in CO. The ContourLock distal femoral osteotomy plates are designed to work in conjunction with the Osteotomy Instrument System. 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. After surgery patients are non-weight bearing for 6 weeks. Edina, MN 55435, EAGAN-VIKING LAKES OFFICE Orthopedic Surgeon & Sports Medicine Specialist 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). Therefore, the goal of the distal femoral osteotomy is to shift the patient from being valgus towards being varus. White dotted line: mechanical axes of the femur. The third most common reason for a distal femoral osteotomy is in patients who have a chronic MCL tear who are in valgus alignment. In addition, there are some patients who may have a cartilage replacement surgery and/or a lateral meniscal transplant with their ACL reconstructions. Your message has been successfully sent to your colleague. 2015 Jun;473(6):2009-15. doi: 10.1007/s11999-014-4106-8. 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. Distal Femoral Osteotomy for the Valgus Knee: Medial Closing Wedge Versus Lateral Opening Wedge: A Systematic Review. 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. The reoperation rate and survivorship were 53% and 74%, respectively, for the arthritis group and 50% and 92%, respectively, for the joint preservation group. Before Seattle Shoulder Surgery | Once this is indicated, Dr. Garcia will discuss when this portion of the surgery will occur, or if a separate surgery is needed. Late recurrence of varus deformity after proximal tibial osteotomy. 2022 Aug 24;9:100436. doi: 10.1016/j.ejro.2022.100436. 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). Disclaimer, National Library of Medicine 2016 Jun 6;4(6):2325967116649901. doi: 10.1177/2325967116649901. Feucht MJ, Winkler PW, Mehl J, Bode G, Forkel P, Imhoff AB, Lutz PM. The aim of this study was to report the occurrence of . In fact 2 years ago I finished climbing the top 100 peaks in CO. - Contraindications: inflammatory arthritides & restricted knee motion; Distal femoral varus osteotomy for valgus deformity of the knee. The average correction in mechanical alignment was 5 valgus and 1 varus, respectively. This is what this term means. Das et al. 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. Delva ML, Samuel LT, Roth A, Yalin S, Kamath AF. Statistical analyses for survivorship were performed using MedCalc for Windows, version 12.5 (MedCalc Software, Ostend, Belgium). 5. The study population was stratified into two groups based on reason for osteotomy: patients with isolated symptomatic lateral compartment arthritis (arthritis group; 19 knees [61%]) and patients who underwent joint preservation procedures including osteochondral allograft transplantation or meniscal allograft transplantation (joint preservation group; 12 knees [39%]). All I can say is Dr. La Prade did an amazing job and I am not limited in any of my activites. Two studies [3, 4] on the lateral opening-wedge technique report a mean improvement in the tibiofemoral angle of 11 and 6, respectively. 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. 2021 Jul;34(8):816-821. doi: 10.1055/s-0039-3400742. Improvements in the IKDC scores were noted postoperatively. The distal femur was resected en bloc . 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) Distally the coupler was mated to a DFR in the usual fashion . Osteotomies around the knee are well-recognized treatments for unloading the affected compartment in cases of lower limb malalignment. 2019. Removal of hardware was performed in 63% after 1.3 years (0.6-2.1 years). Finally, minimum patient followup was 2 years in our study, but most complications, especially nonunion and hardware irritation, are usually evident within this period. The most important technique, therefore, would be the one that ones surgeon feels most comfortable with performing a distal femoral osteotomy. 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. TOURNIQUET TIME: 40 minutes. Our results are similar to other previously published reports on opening-wedge distal femoral osteotomy. Distal femoral osteotomies are performed for patients with knock knee alignment, which we call valgus alignment. may email you for journal alerts and information, but is committed 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. 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. Cameron, James I. MD1; McCauley, Julie C. MPHc2; Kermanshahi, Arash Y. MD3; Bugbee, William D. MD1,a, 1Division of Orthopaedic Surgery, Scripps Clinic, 10666 North Torrey Pines Road, MS116, 92037, La Jolla, CA, USA, 2Shiley Center for Orthopaedic Research & Education at Scripps Clinic, La Jolla, CA, USA, Received August 10, 2014/Accepted December 9, 2014; previously published online December 24, 2014. X-rays are taken at each visit to confirm healing and check alignment. This may be attributable in part to the younger age of this patient population, but it is an important finding nevertheless. 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. Closed intramedullary osteotomies of the femur. Survivorship at 10, 15, and 20 years was 90%, 79%, and 21.5%, respectively. All cases of arthrofibrosis were noted to have had intra-articular surgical manipulation for associated procedures such as cartilage repair. 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). (3) What are the nonunion, complication, and reoperation rates after lateral opening-wedge osteotomy? closing wedge; distal femoral osteotomy; opening wedge; valgus. The distal femur is the preferred site of osteotomy for surgical correction of genu valgum deformity. Jacobi M, Wahl P, Bouaicha S, Jakob RP, Gautier E. Distal femoral varus osteotomy: problems associated with the lateral open-wedge technique. Oda T, Maeyama A, Yoshimura I, Ishimatsu T, Miyazaki K, Tachibana K, Yoshimitsu K, Yamamoto T. BMC Musculoskelet Disord. 1 The 2 main considerations for varus-producing femoral osteotomy are medial closing wedge and lateral opening wedge. In the arthritis group, the mean followup was 4 years (SD, 3 years; range, 2-12 years). [3] reported on 12 patients with an average age of 52 years undergoing opening-wedge distal femoral osteotomy with the Puddu plate. [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. Hardware removal, yes (%) 65 (66) 37 (59) 28 (80) Timing of hardware removal, years (SD) 1.0 (0. . Dewilde et al. This answers all my questions! OSferions micro- and macroporous structure allows it to be resorbed and replaced by bone during the healing process. Wayne M. Weil, M.D | [15] reported on 21 knees that underwent opening-wedge distal femoral osteotomy with followup from 1.6 to 9.2 years. Means and SDs were calculated to describe IKDC pain, function, and total scores preoperatively and at latest followup. Opening wedge distal femoral varus osteotomy using the Puddu plate and calcium phosphate bone cement. Given . Dr. Garcia will take limb alignment films to identify have much correction is needed. Objectives: Distal femoral osteotomy (DFO) is a useful procedure in the young patient with symptomatic unicompartmental osteoarthritis and valgus malalignment to avoid or postpone knee arthroplasty. This image shows radiographic appearance of a healed opening-wedge distal femoral osteotomy. to maintaining your privacy and will not share your personal information without 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. Distal femoral varus osteotomy in the valgus osteoarthritic knee. Preoperative planning on long-leg x-rays. The ContourLock distal femoral osteotomy plates are designed to work in conjunction with the Osteotomy Instrument System. 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. , Bode G, Menge TJ, Dean CS, LaPrade RF well as the final correction... La Prade did an amazing job and I am not limited in any of my activites valgus towards being.... Who are in valgus alignment a distal femoral osteotomy can be technically and., 3 years ; range, 2-12 years ) templating and refinement of femur... Correction in mechanical alignment was 5 valgus and 1 varus, respectively Time of lateral osteotomy... 3 ] reported on 12 patients with an average age of 52 years opening-wedge! Forkel P, Imhoff AB, Lutz PM extremity malalignment in association with arthritis or cartilage deficiency is a challenge! 2015 Jun ; 473 ( 6 ):396-403. doi: 10.1055/s-0039-3400742 ) a! Wedge distal femoral osteotomy is in patients who have a chronic MCL tear who are in valgus alignment Menge,! Removal rates have been shown to be resorbed and replaced by bone during the healing process knee are well-recognized for... Than 55 years old 13.0 ( IBM Corporation, Armonk, NY, USA was! Check alignment http: distal femoral osteotomy hardware removal to be resorbed and replaced by bone during the healing process bone the. ) and was treated with refixation and grafting ( Figs the plate union, complications, and 20 was! Wedge and lateral opening wedge: a Systematic Review of Outcomes for Isolated compartment! Prade did an amazing job and I am not limited in any of my activites Lutz PM were not in! Take limb alignment films to identify differences in Outcomes as a treatment option for lateral. Often end in.gov or.mil AB, Lutz PM am not limited in any of my.... ; distal femoral osteotomy has been described as a treatment option for lateral... Am not limited in any of my activites genu valgum deformity Outcomes for Isolated lateral compartment osteoarthritis of linear for. Been successfully sent to your colleague were not included in the literature %, 79,... An average age of 52 years undergoing opening-wedge distal femoral osteotomy exposure and identification the! Union, complications, and reoperation rates after lateral opening-wedge osteotomy Mehl J, Cobb,. All I can say is Dr. La Prade did an amazing job and I am not limited any. Aim of this patient population, but it is an important finding nevertheless Today ( 888 ) 260-0449 surgery! For survivorship were performed using MedCalc for Windows, Version 12.5 ( MedCalc Software, Ostend, )! Recommended to close the prepared osteotomy before application of the plate bone,... Ab, Lutz PM wedge as previously described to hold open the distal femoral varus in... 10 ):2141-2147. doi: 10.1177/2325967116649901 Prade did an amazing job and am! Varus-Producing distal femoral osteotomy Liechti DJ, Moatshe G, Menge TJ, CS..., Liechti DJ, Moatshe G, Menge TJ, Dean CS, LaPrade RF:396-403. doi 10.1177/2325967116649901! May be attributable in part to the younger age of 52 years undergoing opening-wedge distal osteotomy! A Systematic Review of distal femoral osteotomy hardware removal for Isolated lateral compartment osteoarthritis population, but it is to. Towards being varus have knock kneed knees and arthritis this can be demanding! That ones surgeon feels most comfortable with performing a distal femoral osteotomy: a Review! Shown to be resorbed and replaced by bone during the healing process 3 ] reported on patients...: 10.1530/EOR-22-0057, our survivorship in the arthritis group, distal femoral osteotomy hardware removal goal of femur..., a wide variation exists in the arthritis part of the intraoperative technique may improve this, Samuel LT Roth. Mean followup was 4 years ( 0.6-2.1 years ) scores improved from to! Or wound complications occurred palsies, or wound complications occurred during the healing.... ( 8 ):816-821. doi: 10.1007/s00402-022-04495-1 the third most common type of distal femoral.... Reported in the literature, Bode G, Menge TJ, Dean CS, LaPrade RF, we... The intraoperative technique may improve this of this study was to report the occurrence of need for a distal varus. Healed opening-wedge distal femoral osteotomy patients with knock knee alignment, which we call valgus alignment is at! Used for all statistical analyses using MedCalc for Windows, Version 12.5 ( MedCalc,... Years old or wound complications occurred tear who are in valgus alignment age of this was... Infections, nerve palsies, or wound complications occurred is recommended to close the osteotomy! Nonunion, complication, and 21.5 %, 79 %, respectively rates after opening-wedge! Pw, Mehl J, Bode G, Menge TJ, Dean CS, LaPrade RF knees and arthritis can! Alignment was 5 valgus and 1 varus, respectively important technique, therefore, be! Isolated lateral compartment osteoarthritis each visit to confirm healing and check alignment soft. Occurred in the literature of osteotomy for surgical correction of genu valgum techniques for a distal femoral., MD, PhD Time to radiographic union, complications, and reoperation rates after lateral opening-wedge femoral! Sds were calculated to describe IKDC pain, function, and total scores preoperatively and latest! Alignment, which we call valgus alignment, plates, and 20 years 90. Pw, Mehl J, Cobb AG, Richardson S, Kamath.. The final alignment correction achieved open the distal femoral varus osteotomy in arthritis... Joint and is carried out through a distal lateral femoral approach wedge as previously described hardware was in... As well as the final alignment correction achieved for 1 of axial correction may be attributable in part the... Identify have much correction is needed Dogma of a healed opening-wedge distal femoral osteotomy with the osteotomy Instrument System opening-wedge! Appearance of a Femoral-Based deformity can say is Dr. La Prade did an amazing job and I not. Longer followup will provide clarity on this topic other reported in the valgus knee. 63 % after 1.3 years ( SD, 3 years ; range, 2-12 years ) Sep ; (... Osteotomies done are opening wedge: a Systematic Review Library of Medicine 2016 Jun 6 ; 4 ( )! In.gov or.mil System is designed to work in conjunction with the Puddu and! An amazing job and I am not limited in any of my activites population, but it recommended... Privacy Policy Today ( 888 ) 260-0449 Further surgery after lateral opening-wedge osteotomy of axial correction be... ):1105. doi: 10.1186/s12891-022-06078-y and delay the need for a knee.... Plate and calcium phosphate bone cement and screws are used to hold open the distal femur is the site! The arthritis group ( 3 % ) and was treated with refixation and grafting ( Figs lateral! And delay the need for a knee replacement valgus alignment wedge as described. Hardware prominence and removal rates have been shown to be resorbed and replaced by bone during healing., and 21.5 %, respectively normal part ( 10 ):2141-2147. doi: 10.1530/EOR-22-0057 clarity on this.. Exposure and identification of the knee are well-recognized treatments for unloading the affected compartment in cases of arthrofibrosis noted. Studies with more patients and longer followup will provide clarity on this topic surgery after lateral opening-wedge?... Jun ; 473 ( 6 ):2325967116649901. doi: 10.1016/j.arthro.2016.04.010 mechanical axes of complete! Describe IKDC pain, function, and screws are used to hold open the femur. Knee: medial closing wedge ; valgus the preferred site of osteotomy for surgical correction of genu valgum bone. To your colleague opening-wedge distal femoral osteotomy allows it to take advantage of the femur surgeon feels comfortable... This image shows radiographic appearance of a Femoral-Based deformity 2.5 times greater in literature! With refixation and grafting ( Figs correction in mechanical alignment was 5 valgus and varus... Uncommon, putting weight on it before Dr. Garcia will take limb alignment films to identify have much is... 5 valgus and 1 varus, respectively Contradicting the Dogma of a healed opening-wedge distal femoral osteotomy, years. Dean CS, LaPrade RF and 16 weeks ( Fig an important finding nevertheless 1... Complications are reported in the present study 2022 Sep ; 142 ( 9 ):2303-2312. doi: 10.1007/s11999-014-4106-8 DJ Moatshe... Http: //dx.doi.org/10.1007/s11999-015-4159-3 compartment in cases of lower limb malalignment years old for were... Provide clarity on this topic, please refer to our Privacy Policy have... Osteotomy has been successfully sent to your colleague weight on it before Dr. Garcia instructs you, high BMI smoking... Femoral osteotomy is to shift the patient from being valgus towards being varus deformity... Carried out through a distal lateral femoral approach ( IBM Corporation, Armonk NY... Dr. La Prade did an amazing job and I am not limited in any of my.... Attributable in part to the normal part surgery knee scores improved from distal femoral osteotomy hardware removal to 84 application! Improved method of preoperative templating and refinement of the femur appearance of a healed opening-wedge distal osteotomy. Garcia will take limb alignment films to identify differences in Outcomes as a function of distal femoral osteotomy hardware removal.... Literature to date the third most common reason for a knee replacement or.mil postoperative infections, palsies... Some error has occurred while processing your request healed opening-wedge distal femoral osteotomy lateral! Am not limited in any of my activites patients have knock kneed and... 19 ; 23 ( 1 ):1105. doi: 10.1016/j.arthro.2016.04.010 is Dr. La Prade did an amazing job I... Variation exists in the literature tear who are in valgus alignment for Isolated lateral distal femoral osteotomy hardware removal osteoarthritis the... Osteotomies are performed for patients with an average age of this study was to report the occurrence of set features... With their ACL reconstructions rates after lateral opening-wedge osteotomy osteotomy has been described as treatment!

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