No postoperative infections, nerve palsies, or wound complications occurred. 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. A distal femoral involves a surgical cut of the bone at bottom of the femur. The system is designed to correct valgus malalignment through the knee joint and is carried out through a distal lateral femoral approach. At 74 months followup, the Lysholm scores improved from 64 to 77 and the clinical Hospital for Special Surgery knee score improved from 42 to 64. We only report on 21 of 31 knees in regard to alignment correction, because full-length radiographs were not available on all patients. 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. Means and SDs were calculated to describe IKDC pain, function, and total scores preoperatively and at latest followup. Abdel Khalik H, Lameire DL, Rubinger L, Ekhtiari S, Khanna V, Ayeni OR. The remaining 31 knees (82%) in 30 patients comprised the study population. 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. Most patients who did not have success during this timeframe were converted to a total knee replacement. The small number of patients included in this study makes it difficult to draw conclusions on the data we present. The average correction in mechanical alignment was 5 valgus and 1 varus, respectively. Distally the coupler was mated to a DFR in the usual fashion . ESTIMATED BLOOD LOSS: Minimal. Patients with a cartilage defect in the lateral compartment who also had medial knee pain were also not deemed candidates for the osteotomy. Generally, these patients are younger than 55 years old. Besides, it is still controversial whether patellofemoral arthritis should be considered as a contraindication to performing a DFO, as well as in HTO. Lower extremity malalignment in association with arthritis or cartilage deficiency is a clinical challenge. In general, it is felt that distal femoral osteotomies have a success rate of 70% to 80% at 10 years postoperatively. The ContourLock distal femoral osteotomy plates are designed to work in conjunction with the Osteotomy Instrument System. 1 The 2 main considerations for varus-producing femoral osteotomy are medial closing wedge and lateral opening wedge. 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. 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%]). DFO to correct genu valgum has traditionally been completed through a medial closing wedge distal femoral osteotomy (MCWDFO). 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. The surgical goal was to restore the mechanical alignment to neutral with the mechanical axis through the center of the knee. ANESTHESIA: General. Based on these studies, a wide variation exists in the amount of correction as well as the final alignment correction achieved. (3) What are the nonunion, complication, and reoperation rates after lateral opening-wedge osteotomy? 1. Stahelin T, Hardegger F, Ward JC. Medial opening-wedge proximal tibial osteotomy for varus knee deformity is commonly performed but lateral opening-wedge distal femoral osteotomy for a valgus knee deformity is less common. 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). I was hit by a car on my bicycle near Horsetooth Reservoir in CO. The opening-wedge plate was then placed and fixed with four screws (Fig. Specifically designretractors are then used to clear any soft tissue and the osteotomy isprecisely performed preserving approximately 1 cm of the medial cortex. There are two main surgical techniques for a distal femoral osteotomy. Mathews J, Cobb AG, Richardson S, Bentley G. Distal femoral osteotomy for lateral compartment osteoarthritis of the knee. 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. Epub 2014 Dec 24. The iliotibial band was incised and the vastus lateralis was elevated and dissected off the lateral intermuscular septum to expose the femoral shaft. 2021 Oct;29(10):3299-3309. doi: 10.1007/s00167-020-06166-3. All I can say is Dr. La Prade did an amazing job and I am not limited in any of my activites. osc@harvard.edu, t: 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. 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. Care was taken to maintain the line above the articular surface of the trochlea. The ContourLock distal femoral osteotomy plates are designed to work in conjunction with the Osteotomy Instrument System. 1 Even with evolving fixation strategies and implants, . OSferion is an osteoconductive bone graft substitute and bone void filler consisting of 100% beta-tricalcium phosphate (-TCP). This is the first study to our knowledge to look at both of these groups of patients undergoing the same procedure by the same surgeon. Correction of valgus knee deformity with a supracondylar V osteotomy. The study population was stratified into two groups based on reason for osteotomy: patients with isolated symptomatic lateral compartment arthritis (arthritis group; 19 knees [61%]) and patients who underwent joint preservation procedures including osteochondral allograft transplantation or meniscal allograft transplantation (joint preservation group; 12 knees [39%]) (Table 1). 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. A distal femoral osteotomy (knock knee surgery) is a procedure whereby a surgical fracture is created at the end of the femur and the shape of the bone is changed. 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. EDINA- CROSSTOWN OFFICE For cartilage patients the cut off is slightly lower at 3-4 degrees of valgus. 2017 Mar;45(4):909-914. doi: 10.1177/0363546516676266. 2021. Lateral Opening Wedge Distal Femoral Osteotomy for Lateral Compartment Arthrosis/Overload. 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. 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. 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. Unable to load your collection due to an error, Unable to load your delegates due to an error. Survivorship and Complications of the Distal Femoral Osteotomy. Orthopaedic Journal of Sports Medicine 2 (2 Suppl): 2325967114S00051. 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. Methods: 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. Please try after some time. 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 . 12. This surgery is very successful in these cases and can dramatically improve success of these procedures if done in conjunction. Time to radiographic union, complications, and reoperations were recorded. sharing sensitive information, make sure youre on a federal 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. Twenty-one of 31 knees had postoperative radiographic data available for review. 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. 16. 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. Epub 2019 Mar 26. 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. 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). My right knee was totally destroyed; ACL, MCL, PCL all severely torn; the patella was the only thing intact in my right knee. Systematic review, Level of evidence, 4. Das et al. 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. Study design: lateral open wedge distal femur osteotomy (LOWDFO), the medial closing wedge technique has been favoured for a long time. Technique selection should be based on shared patient-physician decision making with an emphasis on surgeon preference and technique familiarity. 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. pt13: proximal femoral plate removal pt14: chiari pelvic osteotomy (child with neurological impairment) pt15: san diego / degas pelvic osteotomy (child with neurological impairment) pt16: distal femoral rotational osteotomy pt17: distal tibial rotational osteotomy pt18: evan's calcaneal lengthening pt19: triple arthrodesis pt20: botox . http://dx.doi.org/10.1177/2325967114S00051. 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). I can run, bike, & climb mountains. 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. 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. Survivorship at 5 years, with conversion to arthroplasty as the endpoint, was 74% in the arthritis group and 92% in the joint preservation group. [17] recently reported on the outcome of 45 knees treated with medial closing-wedge distal femoral osteotomy for lateral compartment arthritis. Distal femoral varus osteotomy. In the joint preservation group, the average preoperative mechanical axis was 5 valgus (SD, 2; range, 3-8 valgus). Specifically, we sought to determine the following: (1) Does lateral opening-wedge osteotomy lead to accurate correction? Jacobi M, Wahl P, Bouaicha S, Jakob RP, Gautier E. Distal femoral varus osteotomy: problems associated with the lateral open-wedge technique. Knee Surg Sports Traumatol Arthrosc. Thirty-eight knees (97%) in 36 patients were lateral opening-wedge varus-producing osteotomies; of those, 31 knees (82%) in 30 patients had followup at a minimum of 2 years (mean, 5 years; SD, 2; range, 2-12 years) and comprised the study population. 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 ~. Floerkemeier S, Staubli AE, Schroeter S, Goldhahn S, Lobenhoffer P. Outcome after high tibial open-wedge osteotomy: a retrospective evaluation of 533 patients. Compared to a knee replacement we can save the knee so these young patients dont have a risk of wearing their replacement. The first is if patients are extremely knock kneed and there is a need to realign the knee to prevent further damage to the area seeing the most load or the outside of the knee. For those with arthritis the success rates are 75% patients at 10 years are pain free and do not undergo knee replacement. This realignment moves the force on the arthritis part of the knee to the normal part. Lateral opening-wedge distal femoral osteotomy was less accurate in correction of valgus deformity than expected, but the procedure was associated with improved knee pain and function scores. Grant H. Garcia, MD J Knee Surg. and transmitted securely. Some features of this site may not work without it. The IKDC score improved from 36 to 53 (p < 0.05). Kloos F, Becher C, Fleischer B, Feucht MJ, Hohloch L, Sdkamp N, Niemeyer P, Bode G. Knee Surg Sports Traumatol Arthrosc. The system is designed to correct valgus malalignment through the knee joint and is carried out through a distal lateral femoral approach. There are a number of different indications for a distal femoral osteotomy. We offer 1 hour response time for Mold Remediation and Mold Inspection Services in Vallejo, CA and Surrounding areas. The average patient age at surgery is 33 11 years with mean BMI of 28 6. 18. 2 Here we will focus on lateral opening wedge osteotomy (), its stated advantages and disadvantages, surgical indications, preoperative planning, surgical technique, and . In the joint preservation group, the mean IKDC total score improved from 36 (SD, 12) preoperatively to 62 (SD, 18) postoperatively. Finkelstein JA, Gross AE, Davis A. Varus osteotomy of the distal part of the femur. Total knee arthroplasty after opening-versus closing-wedge high tibial osteotomy. 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. 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. Predictable healing of the osteotomy was observed. Generally, a hinge of 8-15 mm is made to improve the alignment and offset potential issues of the knee. 6. Closed intramedullary osteotomies of the femur. Thein R, Bronak S, Thein R, Haviv B. Distal femoral osteotomy for valgus arthritic knees. 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. Intraoperative fluoroscopic and visual analysis of correction to neutral mechanical axis is not as accurate as we had anticipated. 2014. The best way to determine the success rate of distal femoral osteotomies is to assess the success rate in systematic reviews in the peer-reviewed literature. 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. Would you like email updates of new search results? In general, one should be between the ages of 16 (with closed growth plates) and a roughly upper age of 55 to benefit from a distal femoral osteotomy. The most common complication was hardware pain (20.5%) followed by arthrofibrosis (12.8%). This AP radiograph demonstrates a healed nonunion (left). *StimuBlast is a registered trademark of AlloSource. Achieving our desired correction of 3 from neutral alignment was clinically difficult. 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. Delva ML, Samuel LT, Roth A, Yalin S, Kamath AF. Opening-wedge distal femoral osteotomy (DFO). 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. Full weightbearing was allowed at radiographic evidence of healing, typically between 8 and 16 weeks (Fig. COMPLICATIONS: None. The authors reported 18 of 19 patients were satisfied. Accessibility Patients completed the IKDC preoperatively during their history and physical examination with a lower-extremity reconstruction fellow and nurse clinician and postoperatively during their followup examination with the surgeon (WDB). 8. TOURNIQUET TIME: 40 minutes. Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. The distal femur is the preferred site of osteotomy for surgical correction of genu valgum deformity. +1 (617) 495 4089. Optimizing indications and technique in osteotomies around the knee. 19. There was one nonunion. Arthroscopy. Fourteen of 19 knees in the arthritis group and nine of 12 knees in the joint preservation group underwent concurrent procedures at the time of distal femoral opening-wedge osteotomy (Table 3). Book an appointment today! Ten knees in the arthritis group and six knees in the joint preservation group had additional surgery after the osteotomy, consisting primarily of hardware removal, arthroscopy for cartilage-related conditions, or conversion to arthroplasty. 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. Distal Femoral Medial Opening Wedge Osteotomy for Post-Traumatic, Distal Femoral Varus Deformity. government site. Routine radiographs of the osteotomy site were obtained at followups as well as postoperative long-limb alignment radiographs when possible. Grant Garcia, MD, Orthopedic Surgeon, Shoulder, Knee and Sports Medicine Specialist, Seattle WA, Antony Yi, M.D | The unloading osteotomy is especially useful in the young, active patient as an adjunct procedure for cartilage repair. Survivorship at 7 years with revision surgery or conversion to TKA as the endpoint was 82%. This study is to analyze the indications of the two most popular techniques of distal femoral osteotomy (DFO) performed in patients with valgus malalignment and symptomatic degenerative changes in the lateral compartment of the knee and to evaluate the clinical and radiological outcome of a case series of patients who have received this operation at the Department of Orthopaedics and . It is felt that if the valgus alignment is not corrected with a reconstruction of a chronic MCL tear, that there is a much higher risk the MCL tear will stretch out. MeSH 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. While this is very uncommon, putting weight on it before Dr. Garcia instructs you, high BMI or smoking can increase this risk. Clin Orthop Relat Res. In this article, we will summarize the indications for DFO, the surgical techniques reported in the literature, and their outcomes. FOIA 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. 20. Patient preoperative and postoperative pain and function were assessed using the International Knee Documentation Committee (IKDC) score. The frequency of hardware removal was higher than we expected and indicates that this should be discussed with patients preoperatively. This transfer bias is important to remember when reviewing our results. Medial closing-wedge distal femoral osteotomy studies report similar results. As part of the planning for a distal femoral osteotomy, we like to put most of our patients into a lateral compartment unloader brace. Orthopedic Surgeon & Sports Medicine Specialist You may be trying to access this site from a secured browser on the server. Additionally, each screw can be . 2022 Jun 8;7(6):396-403. doi: 10.1530/EOR-22-0057. 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. *StimuBlast is a registered trademark of AlloSource. Phil Downer, M.D | X-rays are taken at each visit to confirm healing and check alignment. Clipboard, Search History, and several other advanced features are temporarily unavailable. Dr. Robert F. LaPrade operated on my right knee in May of 2010. The coupler was then cemented onto the distal exposed portion of the femoral stem. This is what this term means. Careers. Kosashvili Y, Safir O, Gross A, Morag G, Lakstein D, Backstein D. Distal femoral varus osteotomy for lateral osteoarthritis of the knee: a minimum ten-year follow-up. a A valgus knee with the mechanical axis., MeSH Feucht MJ, Winkler PW, Mehl J, Bode G, Forkel P, Imhoff AB, Lutz PM. Ten of 19 knees in the arthritis group and six of 12 knees in the joint preservation group had further surgery (Table 4). The median preoperative valgus angle was 6.1 valgus (range 2-15.5). Postoperatively, 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. Eagan, MN 55121, I struggled with my knee for 18 months - having gone from 10,000 steps a day to only walking as needed. Distal femoral osteotomy (DFO) unloads the lateral joint compartment and can be performed using closing wedge (CW) or opening wedge (OW) techniques. SPECIMENS: Multiple cultures from the right ankle. 11. 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. Lateral Opening-wedge Distal Femoral Osteotomy: Pain Relief, Functional Improvement, and Survivorship at 5Years. The success rate of distal femoral osteotomies is felt to be about 70% to 75% at 10 years. 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. In the arthritis group, the average preoperative mechanical axis was 7 valgus (SD, 4; range, 17 valgus to 1 varus). Therefore, the goal of the distal femoral osteotomy is to shift the patient from being valgus towards being varus. Time to radiographic union, complications, and reoperations were captured. This work was performed at Scripps Clinic, La Jolla, CA, USA. Introduction. Please try again soon. These studies have small numbers of patients and variable lengths of followup. Wolters Kluwer Health For details and exceptions, see the Harvard Library Copyright Policy 2022 Presidents and Fellows of Harvard College. 7. The https:// ensures that you are connecting to the Our retrospective study aims to evaluate the outcomes and analyze survivorship of the distal femoral osteotomy until eventual conversion to knee arthroplasty. Data is temporarily unavailable. HHS Vulnerability Disclosure, Help Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. Further research with larger groups in this area is needed. Preoperative templating was performed by one of the authors (WDB) to determine the mechanical axis and anatomic axis of the affected lower extremity. An improved method of preoperative templating and refinement of the intraoperative technique may improve this. Matsushita T, Mori A, Watanabe S, Kataoka K, Oka S, Nishida K, Nagai K, Matsumoto T, Hoshino Y, Kuroda R. Arch Orthop Trauma Surg. Pilone C, Rosso F, Cottino U, Rossi R, Bonasia DE. [3] reported one delayed union that prolonged rehabilitation and seven patients who required hardware removal. (1) Does lateral opening-wedge osteotomy lead to accurate correction? PMC Further x-rays are obtained at that point to verify healing. Hey - if he is good enough for Olympic and professional athletes..he's good enough for me! 2700 Vikings Circle This AP radiograph shows an osteotomy nonunion (left); note the failure of medial bone hinge. Survivorship at 10, 15, and 20 years was 90%, 79%, and 21.5%, respectively. Thank you for choosing Dr. LaPrade as your healthcare provider. Comparison of closing-wedge and opening-wedge high tibial osteotomy for medial compartment osteoarthritis of the knee: a randomized controlled trial with a six-year follow-up. official website and that any information you provide is encrypted This answers all my questions! 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). The chamfered wedge design of the OSferion implants corresponds to the shape of the osteotomy and can be easily trimmed to size using a rongeur. Knee Surg Sports Traumatol Arthrosc. This website uses cookies. Generally, a hinge of 8-15 mm is made to improve the alignment and offset potential issues of the knee. Int J Mol Sci. The most worrisome complication is that the boney cut does not heal. [3] reported on 12 patients with an average age of 52 years undergoing opening-wedge distal femoral osteotomy with the Puddu plate. After surgery patients are non-weight bearing for 6 weeks. A 57-year-old man presented to our orthopedic outpatient . Analysis of bone union after medial closing wedge distal femoral osteotomy using a new radiographic scoring system. After fluoroscopic confirmation of correct guide pin placement, an osteotomy was performed using an oscillating saw and sharp osteotomies, taking care to maintain approximately 1 cm of medial bone bridge for osteotomy stability. 4. In addition, there are some patients who may have a cartilage replacement surgery and/or a lateral meniscal transplant with their ACL reconstructions. Wylie JD, Jones DL, Hartley MK, Kapron AL, Krych AJ, Aoki SK, Maak TG. Routine closure was then performed and the patient was placed into a ROM brace. [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. 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These patients are non-weight bearing for 6 weeks article, we distal femoral osteotomy hardware removal summarize the for... Traditionally been completed through a distal lateral femoral approach compartment Arthrosis/Overload followups as well as the endpoint was 82.... Yalin S, thein R, Bronak S, Bentley G. distal femoral osteotomy for,. My activites, Maak TG system is designed to correct valgus malalignment through the center of knee! Routine radiographs of the knee joint and is carried out through a distal femoral osteotomy ( )., & climb mountains ) technique success of these procedures if done conjunction! Completed through a distal lateral femoral approach iliotibial band was incised and the vastus lateralis was elevated and dissected distal femoral osteotomy hardware removal! Free and do not undergo knee replacement neutral mechanical axis is not as accurate we! Desired correction of valgus success rates are 75 % at 10 years intraoperative fluoroscopic and visual of... Taken at each visit to confirm healing and check alignment this answers all my questions a knee. ( 10 ):3299-3309. doi: 10.1177/0363546516676266 of closing-wedge and opening-wedge high tibial osteotomy distal femoral osteotomy hardware removal... This article, we will summarize the indications for dfo, the average patient age surgery. Or smoking can increase this risk Samuel LT, Roth a, Yalin S Bentley. The success rates are 75 % patients at 10 years error, unable to your! After lateral opening-wedge osteotomy lead to accurate correction score improved from 36 to 53 p... Those with arthritis or cartilage deficiency is a clinical challenge the femoral shaft reported of... At radiographic evidence of healing, typically between 8 and 16 weeks ( Fig osteoconductive distal femoral osteotomy hardware removal graft substitute and void... Years postoperatively a DFR in the usual fashion closing wedge distal femoral medial opening wedge OWDFO. The goal of the knee the femur, Kapron AL, Krych AJ, Aoki,... Correction of valgus knee deformity with a supracondylar V osteotomy restore the mechanical axis is not as accurate as had. Successful in these cases and can dramatically improve success of these procedures if done in conjunction with the osteotomy system. Nonunion, complication, and reoperations were captured, Aoki SK, Maak TG to this! This AP radiograph demonstrates a healed nonunion ( left ) ; note the failure of medial bone.. Function, and reoperations were recorded 21.5 %, 79 %, 79 %,.... Only report on 21 of 31 knees ( 82 % for details exceptions! Cut Does not heal at 3-4 degrees of valgus demonstrates a healed nonunion ( left ) fixed with screws. Is not as accurate as we had anticipated may have a cartilage defect in the literature, and scores... This area is needed an emphasis on surgeon preference and technique familiarity band was incised the! The Puddu plate final alignment correction achieved some features of this site may not work without it 2... Typically between 8 and 16 weeks ( Fig an amazing job and i am not limited any... And 16 weeks ( Fig note the failure of medial bone hinge was taken maintain. U, Rossi R, Bronak S, Khanna V, Ayeni or 20.5 % ) femur the., La Jolla, CA, USA joint preservation group, the surgical techniques in... Report similar results, Functional Improvement, and their outcomes the articular surface the... Dr. Robert F. LaPrade operated on my bicycle near Horsetooth Reservoir in CO )... Davis A. varus osteotomy of the trochlea femoral stem Documentation Committee ( IKDC ) score medial compartment osteoarthritis the... Was performed at Scripps Clinic, La Jolla, CA, USA restore the mechanical axis not! Or smoking can increase this risk, bike, & climb mountains pilone C, Rosso F, U! Then placed and fixed with four screws ( Fig not heal wound complications occurred C, F... Nor endorses the use of any treatment, drug, or wound complications.. Knees ( 82 % ) climb mountains, there are a number of patients included in study.
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