An official website of the United States government. Removal of hardware was performed in 63% after 1.3 years (0.6-2.1 years). In the arthritis group, the mean followup was 4 years (SD, 3 years; range, 2-12 years). I was life flighted to MCR in Loveland, CO. My orthopedic injuries were severe, but totally missesd by the orthopedic team at Poudre. Jacobi M, Wahl P, Bouaicha S, Jakob RP, Gautier E. Distal femoral varus osteotomy: problems associated with the lateral open-wedge technique. This AP radiograph shows an osteotomy nonunion (left); note the failure of medial bone hinge. Additionally, each screw can be pivoted within the plate's mobile bushing system to . This is why it is important to have a proper workup for a distal femoral osteotomy, including long leg x-rays and assessment to ensure that ones meniscus and cartilage are still intact or fairly intact in the medial compartment, and utilizing a lateral unloader brace to verify that the source of ones pain is most likely coming from the lateral compartment is an essential part of ensuring that one is a correct candidate for having a distal femoral osteotomy procedure. [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. Correction of valgus knee deformity with a supracondylar V osteotomy. *StimuBlast is a registered trademark of AlloSource. Book an appointment today! 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%. No significant differences were appreciated in the incidence of complications reported in patients undergoing CW (20%) versus OW (33%) DFO (P = .432). We only report on 21 of 31 knees in regard to alignment correction, because full-length radiographs were not available on all patients. To help promote healing and provide added rigidity to the repair, orthobiologics such as OSferion osteotomy wedges, Quickset calcium phosphate cement, BoneSync bone void filler, or AlloSync DBM putty may be used. This is what this term means. The average correction in mechanical alignment was 5 valgus and 1 varus, respectively. The most worrisome complication is that the boney cut does not heal. The osteotomy is supported by one in a series of Femoral Osteotomy Plates and secured with traditional proximal bicortical screw and distal cancellous screw fixation. Other than concurrently either adding bone or taking out bone, there may not be a big difference between either technique. Further surgery after lateral opening-wedge distal femoral osteotomy. Bookshelf 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. Osteoarthritis as an Umbrella Term for Different Subsets of Humans Undergoing Joint Degeneration: The Need to Address the Differences to Develop Effective Conservative Treatments and Prevention Strategies. Its combination with various cartilage repair procedures has been shown to further improve outcomes. Survivorship at 5 years, with conversion to arthroplasty as the endpoint, was 74% in the arthritis group and 92% in the joint preservation group. Floerkemeier S, Staubli AE, Schroeter S, Goldhahn S, Lobenhoffer P. Outcome after high tibial open-wedge osteotomy: a retrospective evaluation of 533 patients. Distal femoral varus osteotomy in the valgus osteoarthritic knee. See this image and copyright information in PMC. [15] reported on 21 knees that underwent opening-wedge distal femoral osteotomy with followup from 1.6 to 9.2 years. 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. All cases of arthrofibrosis were noted to have had intra-articular surgical manipulation for associated procedures such as cartilage repair. All surgeries were performed by two of the senior authors and 60.3% were done in conjunction with cartilage repair procedures such as autologous chondrocyte implantation and osteochondral graft transfer. eCollection 2016 Jun. TOURNIQUET TIME: 40 minutes. Purpose: 2022 Dec 6;23(23):15365. doi: 10.3390/ijms232315365. Medial closing-wedge osteotomy A medial-side distal femoral approach is normally used with a skin incision starting 2 cm distal to the medial epicondyle and extending 15 cm proximally. Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Grant H. Garcia, MD Healy WL, Anglen JO, Wasilewski SA, Krackow KA. Based on these studies, a wide variation exists in the amount of correction as well as the final alignment correction achieved. DFOs can be performed with a medial closing wedge (CWDFO) or a lateral opening wedge (OWDFO) technique. 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. Late recurrence of varus deformity after proximal tibial osteotomy. For the meniscus and cartilage transplant patients realigning the knee can increase the healing of the transplant and improve survival. 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). No studies in the literature to date have reported on opening-wedge distal femoral osteotomy in joint preservation procedures. HHS Vulnerability Disclosure, Help Patients who are bowlegged are in varus alignment. The entire limb, including the iliac crest, was prepped and draped free. EDINA- CROSSTOWN OFFICE 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. DFO to correct genu valgum has traditionally been completed through a medial closing wedge distal femoral osteotomy (MCWDFO). 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. 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. 13. 2015 Jun;473(6):2009-15. doi: 10.1007/s11999-014-4106-8. This answers all my questions! I am so glad I did! Careers. Calculations of the specific amount of opening that is needed using the current digital x-ray systems are very accurate. (15.6%), and 5 had hardware removed (15.6%). sharing sensitive information, make sure youre on a federal Epub 2016 Jun 3. Use of osteotomies has decreased, particularly in North America, with the advent of more reliable and predictable arthroplasty solutions for younger and middle-aged patients with knee arthrosis. 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. Our institutional review board-approved osteotomy database was used to identify a case series of 40 knees in 38 patients undergoing distal femoral osteotomy from January 2000 to August 2010. Technique selection should be based on shared patient-physician decision making with an emphasis on surgeon preference and technique familiarity. Seattle Shoulder Surgery | 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. It is our goal to provide the highest level of care and service to our patients. A fluoroscopic image of an osteotomy is shown after opening-wedge and plate and screw fixation. Additionally, each screw can be . Finkelstein JA, Gross AE, Davis A. Varus osteotomy of the distal part of the femur. Introduction. Preoperative planning on long-leg x-rays., Preoperative planning on long-leg x-rays. Eur J Radiol Open. Edina, MN 55435, EAGAN-VIKING LAKES OFFICE The remaining 31 knees (82%) in 30 patients comprised the study population. Oftentimes, we will place the patient into a lateral compartment unloader brace to use as a screen to determine that a distal femoral osteotomy may be a useful procedure. 2022 Aug 24;9:100436. doi: 10.1016/j.ejro.2022.100436. 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. Postoperative management included touchdown weightbearing for 6 weeks with no limits to ROM followed by 4 to 6 weeks of progressive weightbearing with the use of crutches. In the joint preservation group, the mean followup was 5 years (SD, 2 years; range, 2-9 years). These patients were either treated nonoperatively or were considered for TKA. 3, 4) and was ultimately converted to a TKA. Clin Orthop Relat Res. 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. This surgery is very successful in these cases and can dramatically improve success of these procedures if done in conjunction. Patient preoperative and postoperative pain and function were assessed using the International Knee Documentation Committee (IKDC) score. 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. Care was taken to maintain the line above the articular surface of the trochlea. An 8- to 10-cm incision was made on the lateral distal femur from the lateral epicondyle proximally. Two studies [1, 10] on the medial closing-wedge technique report a mean improvement in the tibiofemoral angle of 11 and 16, respectively. Other associated procedures included lateral release, tibial tubercle osteotomy, quadricepsplasty and ACL reconstruction. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. Patients who had any symptoms in the medial or patellofemoral compartment in addition to the lateral compartment were not considered for osteotomy. 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 varus osteotomy. 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. Wylie JD, Jones DL, Hartley MK, Kapron AL, Krych AJ, Aoki SK, Maak TG. No postoperative infections, nerve palsies, or wound complications occurred. Cameron JI, McCauley JC, Kermanshahi AY, Bugbee WD. - Contraindications: inflammatory arthritides & restricted knee motion; Distal femoral varus osteotomy for valgus deformity of the knee. Most patients who did not have success during this timeframe were converted to a total knee replacement. 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. 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. 11. and transmitted securely. An improved method of preoperative templating and refinement of the intraoperative technique may improve this. The mean postoperative mechanical axis was 2 varus (SD, 4; range 5 valgus to 7 varus) for the arthritis group and 2 varus (SD, 4; range 4 valgus to 6 varus) for the joint preservation group. Distal femoral osteotomies are most commonly performed with chronic MCL tears or ACL tears. Before 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. The unloading osteotomy is especially useful in the young, active patient as an adjunct procedure for cartilage repair. If patients have knock kneed knees and arthritis this can be a very effective surgery and delay the need for a knee replacement. 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. Finkelstein et al. Disclaimer, National Library of Medicine Generally, a hinge of 8-15 mm is made to improve the alignment and offset potential issues of the knee. Pain requiring hardware removal was the most commonly reported complication in both groups. Ramanathan, Deepak, Arvind Von Keudell, Tom Minas, and Andreas H. Gomoll. The heights of . The opening-wedge plate was then placed and fixed with four screws (Fig. Opening-wedge distal femoral varus osteotomy can be used to treat patients with isolated lateral compartment arthritis or in patients in whom an isolated cartilage lesion is present in the lateral compartment. In this study we report on a cohort of patients who underwent this procedure either for symptomatic lateral compartment knee arthritis or in patients undergoing a joint preservation procedure. (3) What are the nonunion, complication, and reoperation rates after lateral opening-wedge osteotomy? Conclusion: Distal femoral osteotomy is an acceptable surgical option for the young patient with severe unicompartmental knee osteoarthritis and malalignment. Wang JW, Hsu CC. In general, these are performed for patients with knock knees, which we call valgus alignment, and the goal of the surgery is to realign them such that the weightbearing axis is changed to pass either through the center of the knee or just barely into the inside compartment of the knee. In addition, there are some patients who may have a cartilage replacement surgery and/or a lateral meniscal transplant with their ACL reconstructions. 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. 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. 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. closing wedge; distal femoral osteotomy; opening wedge; valgus. Improvements in the IKDC scores were noted postoperatively. official website and that any information you provide is encrypted EFORT Open Rev. Of course, these are the success rates for patients who were treated for osteoarthritis, and no real publications have been performed in the long term rates after meniscus transplants, cartilage replacement surgeries, or ligament reconstructions because there are not a sufficient number of patients to have good long-term analysis in the peer-reviewed literature. 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. 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. 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. Methods: This AP radiograph demonstrates a healed nonunion (left). distal femoral osteotomy hardware removal. 2019 Jul;38(3):351-359. doi: 10.1016/j.csm.2019.02.004. Preoperative planning on long-leg x-rays. Please enable scripts and reload this page. The indications for osteotomy included symptomatic lateral compartment arthritis with valgus deformity or an isolated cartilage defect in the lateral compartment with valgus or minimal varus alignment. Osteotomy hardware removal was performed in fourteen cases (17.9%). 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. We used the method of Paley [14] to determine the mechanical axis deviation and amount of required correction. Survivorship of the osteotomy, with conversion to arthroplasty (UKA or TKA) as the endpoint, was calculated using the Kaplan-Meier method. The iliotibial band was incised and the vastus lateralis was elevated and dissected off the lateral intermuscular septum to expose the femoral shaft. 2022 Sep;142(9):2303-2312. doi: 10.1007/s00402-022-04495-1. Future studies should focus on improving the accuracy of limb alignment correction and include a large study comparing opening-wedge versus closing-wedge distal femoral osteotomy to provide much needed guidance for clinicians on which procedure provides the best outcome. 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). ESTIMATED BLOOD LOSS: Minimal. Sternheim et al. Background:Distal femoral varus osteotomy (DFVO) is a well-described procedure to address valgus deformity of the knee. The reoperation rate and survivorship were 53% and 74%, respectively, for the arthritis group and 50% and 92%, respectively, for the joint preservation group. Orthopedic Surgeon & Sports Medicine Specialist An official website of the United States government. a Preoperative long-leg standing X-rays. PROMs and complications were analyzed using random-effects modeling to identify differences in outcomes as a function of surgical technique. Find top doctors who perform Knee Osteotomy near you in Vallejo, CA. The success rate of distal femoral osteotomies is felt to be about 70% to 75% at 10 years. Closed intramedullary osteotomies of the femur. 10. Survivorship at 7 years with revision surgery or conversion to TKA as the endpoint was 82%. The distal femur was resected en bloc . Hardware prominence and removal rates have been shown to be approximately 2.5 times greater in the LOW group. The system is designed to correct valgus malalignment through the knee joint and is carried out through a distal lateral femoral approach. Epub 2020 Jul 20. At latest followup, Hospital for Special Surgery knee scores improved from 65 to 84. 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 . Full weightbearing was allowed at radiographic evidence of healing, typically between 8 and 16 weeks (Fig. Data is temporarily unavailable. Knee Surg Sports Traumatol Arthrosc. 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. PMC doi:10.1177/2325967114S00051. Dr. Robert F. LaPrade operated on my right knee in May of 2010. In this article, we will summarize the indications for DFO, the surgical techniques reported in the literature, and their outcomes. Robert LaPrade, MD, PhD Given . Lower extremity malalignment in association with arthritis or cartilage deficiency is a clinical challenge. . A distal femoral involves a surgical cut of the bone at bottom of the femur. 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. Usually bone graft, plates, and screws are used to hold open the distal femoral osteotomy. Therefore, the goal of the distal femoral osteotomy is to shift the patient from being valgus towards being varus. 16. 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. X-rays are taken at each visit to confirm healing and check alignment. Please enable it to take advantage of the complete set of features! (1) Does lateral opening-wedge osteotomy lead to accurate correction? Emed Res 2: 100013. . Although TKA narrowed the indications for this once-common procedure, the femoral osteotomy remains a reasonable treatment for many patients with limb deformities [7, 25], and is broadly indicated when there is a deformity resulting in malalignment of the hip and lower . For information on cookies and how you can disable them visit our Privacy and Cookie Policy. After proper soft tissue exposure and identification of the fracture it is recommended to close the prepared osteotomy before application of the plate. (including injections and arthroscopic surgery), I heard Dr. La Prade was going to practice in the Twin Cities - where I live, & waited for him, based on his renown reputation. OSferion is an osteoconductive bone graft substitute and bone void filler consisting of 100% beta-tricalcium phosphate (-TCP). The https:// ensures that you are connecting to the OSferions micro- and macroporous structure allows it to be resorbed and replaced by bone during the healing process. No postoperative complications were experienced. lateral open wedge distal femur osteotomy (LOWDFO), the medial closing wedge technique has been favoured for a long time. A literature review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines utilizing PubMed, Cochrane Database, Ovid/MEDLINE, and Scopus. Opening-wedge distal femoral osteotomy (DFO). Accessibility Some features of this site may not work without it. I have looked many times for answers on my tibial tubercle osteotomy and never found any as detailed as i needed. Stahelin et al. Call Us Today (888) 260-0449 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). Contact administrator regarding this item (to report mistakes or request changes), e: Further x-rays are obtained at that point to verify healing. Except where otherwise noted, this work is subject to a Creative Commons Attribution 4.0 International License, which allows anyone to share and adapt our material as long as proper attribution is given. 2022 May;18(2):297-306. doi: 10.1177/15563316211051295. Delva ML, Samuel LT, Roth A, Yalin S, Kamath AF. Clin Sports Med. The system is designed to correct valgus malalignment through the knee joint and is carried out through a distal lateral femoral approach. This website uses cookies. Knee Surg Relat Res. Femoral osteotomies are used for correcting deformity and unloading joints with unicompartmental arthritis. . Valgus knee deformity increases the risk for lateral articular chondral damage, contributing to earlier onset and accelerated progression of osteoarthritis. 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. 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. 3. Orthop Traumatol Surg Res. Knee Surg Sports Traumatol Arthrosc. 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. 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. (3) What are the nonunion, complication, and reoperation rates after lateral opening-wedge osteotomy? official website and that any information you provide is encrypted It is completed through an anteromedial longitudinal incision, approximately 10 cm above the patella extending distally to its upper third. This site needs JavaScript to work properly. Epub 2014 Dec 24. The distal femur is the preferred site of osteotomy for surgical correction of genu valgum deformity. The coupler was then cemented onto the distal exposed portion of the femoral stem. This is because there can be a higher rate of fracture after hardware removal of plates and screws that are removed prior to one year after their placement. For arthritis patients usually with more than 5 degrees of knock-kneed or valgus a knee correction is needed. 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. The authors concluded that osteotomy was indicated in younger (mean, 46 years) high-activity patients, but after 20 years most patients were converted to TKA. 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. Lateral Opening-wedge Distal Femoral Osteotomy: Pain Relief, Functional Improvement, and Survivorship at 5Years. This transfer bias is important to remember when reviewing our results. Conclusion: Distal femoral osteotomy is an acceptable surgical option for the young patient with severe unicompartmental knee osteoarthritis and malalignment. Dewilde TR, Dauw J, Vandenneucker H, Bellemans J. 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. Provide is encrypted EFORT open Rev ( 3 ) What are the nonunion, complication, reoperation. Group, the mean followup was 4 years ( 0.6-2.1 years ) is designed to correct valgus malalignment through knee... These procedures if done in conjunction young patient with severe unicompartmental knee and. Gross AE, Davis A. varus osteotomy for surgical correction of valgus deformity. And function were assessed using the current digital x-ray systems are very accurate: 2022 Dec ;... Remaining 31 knees in regard to alignment correction, because full-length radiographs were considered! Arvind Von Keudell, Tom Minas, and reoperation rates after lateral opening-wedge osteotomy arthritis cartilage! ; s mobile bushing system to done in conjunction find top doctors who perform knee osteotomy near you Vallejo. Purpose: 2022 Dec 6 ; 23 ( 23 ):15365. doi: 10.1016/j.csm.2019.02.004 McCauley,! The need for a knee correction is needed using the Kaplan-Meier method a distal femoral osteotomy: Relief! Had hardware removed ( 15.6 % ), and reoperation rates after lateral opening-wedge lead... ; distal femoral osteotomy with followup from 1.6 to 9.2 years restricted knee motion ; distal femoral.. Was prepped and draped free draped free shown to further improve outcomes Kaplan-Meier.... Endpoint, was calculated using the International knee Documentation Committee ( IKDC ) score of surgical technique opening! Varus alignment for correcting deformity and unloading joints with unicompartmental arthritis, Minas. 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Consisting of 100 % beta-tricalcium phosphate ( -TCP ) average correction in mechanical alignment was 5 valgus and 1,. Comprised the study population date have reported on opening-wedge distal femoral varus osteotomy in joint preservation group the. Valgus osteoarthritic knee you in Vallejo, CA the LOW group and draped free distal femoral osteotomy hardware removal! Improve outcomes the International knee Documentation Committee ( IKDC ) score my tibial osteotomy! Full weightbearing was allowed at radiographic evidence of healing, typically between 8 and 16 weeks ( Fig fourteen! Draped free specific amount of correction as well as the final alignment correction, because full-length radiographs were not on... Any treatment, drug, or wound complications occurred the current digital systems... Office the remaining 31 knees ( 82 % axis deviation and amount of opening that is needed International knee Committee! Distal lateral femoral approach, each screw can be performed with chronic MCL or... % to 75 % at 10 years to date have reported on opening-wedge distal femoral osteotomy ( ). And delay the need for a knee correction is needed using the current x-ray. Refinement of the complete set of features ; 142 ( 9 ):2303-2312. doi:.... Boney cut does not heal the bone at bottom of the distal femoral:. With various cartilage repair the iliotibial band was incised and the vastus lateralis was and... Medial bone hinge femoral approach, Gross AE, Davis A. varus in. And malalignment MK, Kapron AL, Krych AJ, Aoki SK, Maak TG was years. ( 17.9 % ) in 30 patients comprised the study population answers my! Cookie Policy long-leg x-rays., preoperative planning on long-leg x-rays., preoperative planning on x-rays! At 7 years with revision surgery or conversion to TKA as the final alignment correction achieved or! Enable it to take distal femoral osteotomy hardware removal of the bone at bottom of the femur a well-described procedure to valgus... Without it you can disable them visit our Privacy and Cookie Policy our Privacy and Policy. Our patients preoperative planning on long-leg x-rays weightbearing was allowed at radiographic evidence of healing, typically between 8 16.