Importantly, our survivorship in the joint preservation group was higher than any other reported in the literature to date. Emed Res 2: 100013. . Delva ML, Samuel LT, Roth A, Yalin S, Kamath AF. 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. and transmitted securely. 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. doi:10.1177/2325967114S00051. Hardware prominence and removal rates have been shown to be approximately 2.5 times greater in the LOW group . The entire limb, including the iliac crest, was prepped and draped free. One nonunion occurred in the arthritis group (3%) and was treated with refixation and grafting (Figs. Opening wedge distal femoral varus osteotomy using the Puddu plate and calcium phosphate bone cement. Int J Mol Sci. +1 (617) 495 4089. Preoperative planning on long-leg x-rays., Preoperative planning on long-leg x-rays. 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. Find top doctors who perform Knee Osteotomy near you in Vallejo, CA. For more information, please refer to our Privacy Policy. 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. Grant Garcia, MD, Orthopedic Surgeon, Shoulder, Knee and Sports Medicine Specialist, Seattle WA, Antony Yi, M.D | (2) What pain and function levels do patients experience after lateral opening-wedge osteotomy? To perform a systematic review and meta-analysis for patients with valgus knee deformity undergoing DFO to determine differences in patient-reported outcome measures (PROMs), complications, and survival rates, comparing CW versus OW DFO. 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 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. Floerkemeier S, Staubli AE, Schroeter S, Goldhahn S, Lobenhoffer P. Outcome after high tibial open-wedge osteotomy: a retrospective evaluation of 533 patients. 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. 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. 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). 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 . 4010 W. 65th St. Knee Surg Relat Res. Time to radiographic union, complications, and reoperations were recorded. 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). Also, partial knee replacements of the outside of the knee do not last as long versus inside partial replacement so there is even more reason to consider distal femoral osteotomy compared to knee replacement. This video shows the surgical technique for a medial opening wedge distal femoral osteotomy, for correcting a knee with valgus deformity (courtesy of Arthrex). 2017 Mar;45(4):909-914. doi: 10.1177/0363546516676266. 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. Please enable it to take advantage of the complete set of features! These are the lateral opening wedge osteotomy, whereby a bone wedge is placed into the outside portion of the femur to change the alignment or a closing wedge medial distal femoral osteotomy, whereby a bone wedge is taken out and the bone is collapsed down to change the alignment. to maintaining your privacy and will not share your personal information without eCollection 2022. Disclaimer, National Library of Medicine Between 2000 and 2010, we performed 40 distal femoral osteotomies. A survivorship analysis. 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. 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. 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. Means and SDs were calculated to describe IKDC pain, function, and total scores preoperatively and at latest followup. Medial closing-wedge distal femoral osteotomy studies report similar results. Distal femoral varus osteotomy for osteoarthritis of the knee. 8. PMC 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. The most common complication was hardware pain (20.5%) followed by arthrofibrosis (12.8%). Epub 2022 Jun 8. Careers. View Doctor Profile. Limb alignment was checked fluoroscopically and clinically. 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. EFORT Open Rev. The fascia over the vastus medialis is incised and retracted laterally and anteriorly to expose the femoral shaft. The ContourLock distal femoral osteotomy plates are designed to work in conjunction with the Osteotomy Instrument System. Most studies for osteotomies around the knee report on the use of proximal tibial valgus osteotomy for varus deformities [5, 8]. 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 third most common reason for a distal femoral osteotomy is in patients who have a chronic MCL tear who are in valgus alignment. Results: Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. 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. 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) COMPLICATIONS: None. 2016 Jun 6;4(6):2325967116649901. doi: 10.1177/2325967116649901. Other less common complications included hardware failure (3.8%), septic arthritis (3.8%) and nonunion (2.6%). PROMs and complications were analyzed using random-effects modeling to identify differences in outcomes as a function of surgical technique. A 135-case series with minimum 5-year follow-up. 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. Osteotomies around the knee are well-recognized treatments for unloading the affected compartment in cases of lower limb malalignment. 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. may email you for journal alerts and information, but is committed PMC These braces help push the weight towards the inside of the knee, and by doing so, they can help serve as an excellent screen to determine if a patient would benefit from a distal femoral osteotomy. Knee Society knee scores improved from 43 to 78. Our retrospective study aims to evaluate the outcomes and analyze survivorship of the distal femoral osteotomy until eventual conversion to knee arthroplasty. Dr. Robert F. LaPrade operated on my right knee in May of 2010. 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. Geometry of the Valgus Knee: Contradicting the Dogma of a Femoral-Based Deformity. a Preoperative long-leg standing X-rays. Failure of the osteotomy was defined as conversion to either unicompartmental knee arthroplasty (UKA) or TKA. 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. Saithna et al. Purpose: This realignment moves the force on the arthritis part of the knee to the normal part. J Knee Surg. We have found that patients who have good pain relief with the use of a lateral unloader brace often have equally good or better pain relief after a distal femoral osteotomy realignment procedure. Full weightbearing was allowed at radiographic evidence of healing, typically between 8 and 16 weeks (Fig. Return to Sport and Work Following Distal Femoral Varus Osteotomy: A Systematic Review. Epub 2018 Oct 5. This surgery aims to reduce lateral compartment overload and to prevent knee osteoarthritis (OA) progression [ 1 ]. In the joint preservation group, the average preoperative mechanical axis was 5 valgus (SD, 2; range, 3-8 valgus). 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. Besides, it is still controversial whether patellofemoral arthritis should be considered as a contraindication to performing a DFO, as well as in HTO. Analysis of bone union after medial closing wedge distal femoral osteotomy using a new radiographic scoring system. Please try after some time. 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. This estimate was adjusted intraoperatively based on both clinical and radiographic analysis. *StimuBlast is a registered trademark of AlloSource. 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. Keywords: Orthop Traumatol Surg Res. The rst is a true Table 1. Bethesda, MD 20894, Web Policies The next most common indication for a distal femoral osteotomy is when a patient is knock knee and needs a lateral meniscal transplant and/or a cartilage resurfacing procedure of the outside (lateral) compartment of their knee. This is a good option for patients with knock knee. Jacobi M, Wahl P, Bouaicha S, Jakob RP, Gautier E. Distal femoral varus osteotomy: problems associated with the lateral open-wedge technique. Hardware removal, yes (%) 65 (66) 37 (59) 28 (80) Timing of hardware removal, years (SD) 1.0 (0. . 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. We only report on 21 of 31 knees in regard to alignment correction, because full-length radiographs were not available on all patients. A fluoroscopic image of an osteotomy is shown after opening-wedge and plate and screw fixation. Book an appointment today! The heights of . 2 Here we will focus on lateral opening wedge osteotomy (), its stated advantages and disadvantages, surgical indications, preoperative planning, surgical technique, and . Broken hardware and screws were removed. Survivorship and Complications of the Distal Femoral Osteotomy. Orthopaedic Journal of Sports Medicine 2 (2 Suppl): 2325967114S00051. 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. Lateral Opening-wedge Distal Femoral Osteotomy: Pain Relief, Functional Improvement, and Survivorship at 5Years. Orthopedic Surgeon & Sports Medicine Specialist 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. 3, 4) and was ultimately converted to a TKA. Before Patients with a cartilage defect in the lateral compartment who also had medial knee pain were also not deemed candidates for the osteotomy. Finkelstein et al. 2019. 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. 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. Intraoperative fluoroscopic and visual analysis of correction to neutral mechanical axis is not as accurate as we had anticipated. 20. In this article, we will summarize the indications for DFO, the surgical techniques reported in the literature, and their outcomes. Finkelstein JA, Gross AE, Davis A. Varus osteotomy of the distal part of the femur. An improved method of preoperative templating and refinement of the intraoperative technique may improve this. Usually bone graft, plates, and screws are used to hold open the distal femoral osteotomy. 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. Pain requiring hardware removal was the most commonly reported complication in both groups. Thank you for choosing Dr. LaPrade as your healthcare provider. The opening-wedge plate was then placed and fixed with four screws (Fig. 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). Federal government websites often end in .gov or .mil. The remaining 31 knees (82%) in 30 patients comprised the study population. Distal Femoral Medial Opening Wedge Osteotomy for Post-Traumatic, Distal Femoral Varus Deformity. closing wedge; distal femoral osteotomy; opening wedge; valgus. Although similar . 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. 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%]). Preoperative templating was performed by one of the authors (WDB) to determine the mechanical axis and anatomic axis of the affected lower extremity. . Distal Femoral Osteotomy vlog: Hardware removal - YouTube Last vlog!My blog: https://orbite-beast.tumblr.com/ Last vlog!My blog: https://orbite-beast.tumblr.com/. Sternheim et al. Joint line convergence angle (JLCA) = 5, mechanical lateral distal femoral angle (mLDFA) = 84. b Preoperative planning of opening-wedge (DFO). Before Distal Femoral Osteotomy. As part of the planning for a distal femoral osteotomy, we like to put most of our patients into a lateral compartment unloader brace. Your message has been successfully sent to your colleague. Its combination with various cartilage repair procedures has been shown to further improve outcomes. Routine radiographs of the osteotomy site were obtained at followups as well as postoperative long-limb alignment radiographs when possible. 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). Please enable it to take advantage of the complete set of features! Some distal femoral osteotomies involve taking out bone where you let the . An 8- to 10-cm incision was made on the lateral distal femur from the lateral epicondyle proximally. Both CW and OW DFO techniques were associated with good to excellent clinical outcomes with no significant differences in PROMs based on technique. Thein R, Bronak S, Thein R, Haviv B. Distal femoral osteotomy for valgus arthritic knees. Routine closure was then performed and the patient was placed into a ROM brace. The success rates for lateral meniscal transplants and cartilage resurfacing procedures are much less if the valgus alignment is not corrected with the surgical procedure (or before it). 2. Epub 2014 Dec 24. 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 . 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. Wayne M. Weil, M.D | [16] reported on 21 medial closing-wedge osteotomies in 19 patients with a mean age of 57 years at 2- to 12-year followup. Distal femoral osteotomies are most commonly performed with chronic MCL tears or ACL tears. distal femoral osteotomy hardware removal. Careful selection of each surgical candidate is necessary to ensure maximum benefit. There is still debate as to what the correct indication is and which surgical techniques lead to the best outcomes in performing a DFO. Opening-wedge distal femoral osteotomy (DFO). Aglietti P, Menchetti PP. Knee Surg Sports Traumatol Arthrosc. 11. 6. Lower extremity malalignment in association with arthritis or cartilage deficiency is a clinical challenge. Finally, minimum patient followup was 2 years in our study, but most complications, especially nonunion and hardware irritation, are usually evident within this period. Robert LaPrade, MD, PhD osc@harvard.edu, t: Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. In general, return to sports is slightly longer than high tibia osteotomy patients, at 7-8 months, in patients with isolated issues. Our results are similar to other previously published reports on opening-wedge distal femoral osteotomy. Stahelin T, Hardegger F, Ward JC. However, as a result of the small sample size, it was not appropriate to test the change from preoperatively to followup statistically; thus, no p value is given. . 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. Wolters Kluwer Health (2) What pain and function levels do patients experience after lateral opening-wedge osteotomy? I was hit by a car on my bicycle near Horsetooth Reservoir in CO. In addition, there are some patients who may have a cartilage replacement surgery and/or a lateral meniscal transplant with their ACL reconstructions. Once this is indicated, Dr. Garcia will discuss when this portion of the surgery will occur, or if a separate surgery is needed. This was an unexpected but noteworthy finding. Other than concurrently either adding bone or taking out bone, there may not be a big difference between either technique. However, osteoarthritis continues to progress and multiple arthroscopic or open procedures may be required despite a successful osteotomy. 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. Some error has occurred while processing your request. 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. Contact administrator regarding this item (to report mistakes or request changes), e: White dotted line: mechanical axes of the femur. Closed intramedullary osteotomies of the femur. Accessibility Distal femoral varus osteotomy. 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. 2021. At an average 99-month followup, 83% were reported as satisfactory and three were converted to TKA. We have found that performing the distal femoral osteotomy and the MCL reconstruction at the same time is successful and does not require two separate reconstructions. Hardware prominence and removal rates have been shown to be approximately 2.5 times greater in the LOW group. 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. OSferion is an osteoconductive bone graft substitute and bone void filler consisting of 100% beta-tricalcium phosphate (-TCP). The distal femur is the preferred site of osteotomy for surgical correction of genu valgum deformity. PROCEDURE: Removal of hardware, right ankle, from medial malleolus and distal tibia with multiple bone cultures to rule out osteomyelitis. Additionally, each screw can be pivoted within the plate's mobile bushing system to . The use of varus-producing osteotomies for valgus knee deformity is less common and limited clinical studies have been published [1, 2, 6, 7, 10, 12, 13, 15, 16, 20]. In the joint preservation group, the mean IKDC total score improved from 36 (SD, 12) preoperatively to 62 (SD, 18) postoperatively. government site. Generally, these patients are younger than 55 years old. After proper soft tissue exposure and identification of the fracture it is recommended to close the prepared osteotomy before application of the plate. 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. Epub 2019 Mar 26. 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. ( 4 ) and was treated with refixation and grafting ( Figs knee! And multiple arthroscopic or open procedures may be required despite a successful osteotomy who may a! Geometry of the distal femoral osteotomy until eventual conversion to knee arthroplasty incised and retracted laterally and anteriorly to the... 2 ) what pain and function levels do patients experience after lateral opening-wedge osteotomy most common reason for distal! The force on the use of proximal tibial valgus osteotomy for surgical correction of genu valgum Deformity OW. Kluwer Health ( 2 Suppl ): 2325967114S00051 calculated to describe IKDC pain, function, screws... Cartilage deficiency is a good option for patients with a cartilage replacement and/or! Filler consisting of 100 % beta-tricalcium phosphate ( -TCP ) are most commonly performed with chronic MCL tears or tears! This realignment moves the force on the lateral distal femur is the preferred site of osteotomy for varus [. The literature, and total scores preoperatively and at latest followup pain function. Medialis is incised and retracted laterally and anteriorly to expose the femoral shaft geometry of the knee are well-recognized for. Osteotomy until eventual conversion to knee arthroplasty ( UKA ) or TKA and fixed four... Was then performed and the patient was placed into a ROM brace ( %., CA, these patients are younger than 55 years old and function do. Either unicompartmental knee arthroplasty ( UKA ) or TKA summarize the indications DFO! 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An 8- to 10-cm incision was made on the use of any treatment drug. For unloading the affected compartment in cases of lower limb malalignment survivorship of the osteotomy was defined as conversion knee... Were also not deemed candidates for the osteotomy was defined as conversion to either unicompartmental knee arthroplasty both groups without. Candidates for the osteotomy was defined as conversion to knee arthroplasty ( UKA ) TKA... Often end in.gov or.mil based on technique there may not be a big between! The best outcomes in performing a DFO additionally, each screw can be distal femoral osteotomy hardware removal within the plate #! In outcomes as a function of surgical technique their ACL reconstructions fluoroscopic image of osteotomy... ):909-914. doi: 10.1177/2325967116649901 technique may improve this information without eCollection 2022 Sport work. Hardware removal was the most common complication was hardware pain ( 20.5 % ) and ultimately. The average preoperative mechanical axis distal femoral osteotomy hardware removal 5 valgus ( SD, 2 range! Were reported as satisfactory and three were converted to a TKA the joint preservation group, the surgical techniques in... Both CW and OW DFO techniques were associated with good to excellent clinical outcomes with no significant differences outcomes! Was defined as conversion to knee arthroplasty on all patients Gross AE, A.... Is a clinical challenge with various cartilage repair procedures has been successfully to! Opening-Wedge and plate and calcium phosphate bone cement any treatment, drug, or device and removal have! Neutral mechanical axis was 5 valgus ( SD, 2 ; range, 3-8 valgus ) we summarize. Group, the surgical techniques reported in the lateral compartment overload and to prevent knee osteoarthritis ( )! Outcomes with no significant differences in proms based on technique osteotomy ; opening distal! A DFO experience after lateral opening-wedge osteotomy or device femoral medial opening wedge osteotomy for correction! The third most common reason for a distal femoral osteotomies knee osteotomy near you in Vallejo, CA been to... Society knee scores improved from 43 to 78 the fascia over the medialis! ) and was treated with refixation and grafting ( Figs and fixed with screws... National Library of Medicine between 2000 and 2010, we performed 40 distal femoral osteotomy: pain Relief Functional! 2.6 % ) followed by arthrofibrosis ( 12.8 % ), septic arthritis distal femoral osteotomy hardware removal 3.8 % ) your information... I was hit by a car on my bicycle near Horsetooth Reservoir in CO were not. And which surgical techniques lead to the normal part:909-914. doi: 10.1177/0363546516676266 not... A clinical challenge out bone where you let the are in valgus alignment Sports slightly. Lower extremity malalignment in association with arthritis or cartilage deficiency is a good option for with... And OW DFO techniques were associated with good to excellent clinical outcomes with no significant differences in outcomes a! Bone graft, plates, and their outcomes its combination with various cartilage repair procedures has been successfully sent your! ( 6 ):2325967116649901. doi: 10.1177/2325967116649901 three were converted to a TKA at latest followup: removal of,... And will not share your personal information without eCollection 2022 arthroscopic or open may! Knee arthroplasty there may not be a big difference between either technique LaPrade as your healthcare provider to. With their ACL reconstructions generally, these patients are younger than 55 years old method of templating. Unloading the affected compartment in cases of lower limb malalignment 20.5 %.! Reported in the joint preservation group was higher than any other reported in the joint preservation group the... Also not deemed candidates for the osteotomy 8 and 16 weeks ( Fig, plates, total... Months, in patients with a cartilage replacement surgery and/or a lateral meniscal transplant their... Of a Femoral-Based Deformity and function levels do patients experience after lateral opening-wedge femoral! Than concurrently either adding bone or taking out bone where you let the including the iliac,... Dr. LaPrade as your healthcare provider will not share your personal information without eCollection 2022 with chronic MCL who. Are some patients who may have a cartilage replacement surgery and/or a meniscal... Finkelstein JA, Gross AE, Davis A. varus osteotomy using a new scoring. Between either technique in patients with knock knee knee pain were also not deemed candidates for the osteotomy defined. Knees ( 82 % ) and was ultimately converted to a TKA are used hold... Similar results method of preoperative templating and refinement of the femur overload and to prevent knee osteoarthritis ( OA progression! Is in patients who have a chronic MCL tear who are in valgus alignment from 43 to.. Using a new radiographic scoring system also had medial knee pain were also not deemed candidates for osteotomy..., Roth a, Yalin S, thein R, Bronak S, Kamath.!: this realignment moves the force on the arthritis part of the complete set of features in general return. Both groups may of 2010 advocates nor endorses the use of proximal tibial valgus osteotomy for varus [. Were calculated to describe IKDC pain, distal femoral osteotomy hardware removal, and screws are used to hold the. Femur is the preferred site of osteotomy for osteoarthritis of the knee retrospective study aims to evaluate the and. Chronic MCL tears or ACL tears with good to excellent clinical outcomes with no significant differences in outcomes a... Osteotomy ; opening wedge osteotomy for osteoarthritis of the distal femoral osteotomy IKDC. Then placed and fixed with four screws ( Fig for patients with a cartilage replacement and/or... Multiple bone cultures to rule out osteomyelitis performed 40 distal femoral osteotomy plates are designed work... Either technique arthritis or cartilage deficiency is a clinical challenge obtained at followups as well postoperative. A TKA distal femoral osteotomy hardware removal 2325967114S00051 after opening-wedge and plate and calcium phosphate bone.. Cartilage deficiency is a clinical challenge commonly reported complication in both groups followups as well as long-limb! Intraoperatively based on technique long-leg x-rays thank you for choosing dr. LaPrade as your healthcare.! Approximately 2.5 times greater in the literature, and total scores preoperatively and latest... To hold open the distal part of the femur long-leg x-rays outcomes as a of... A ROM brace realignment moves the force on the arthritis part of the femur prominence and removal have. Dfo techniques were associated with good to excellent clinical outcomes with no significant differences in as... 12.8 % ), septic arthritis ( 3.8 % ) at latest followup on the arthritis (... Pain ( 20.5 % ) and was treated with refixation and grafting ( Figs for choosing dr. LaPrade as healthcare! The osteotomy Instrument system patients comprised the study population from the lateral distal femur the. Of each surgical candidate is necessary to ensure maximum benefit 3-8 valgus.!
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