Distal femoral varus osteotomy: results of the lateral open-wedge technique without bone grafting

Kolb, Alexander; Isak, Verena; Hobusch, Gerhard M.; Chiari, Catharina; Windhager, Reinhard

doi:10.1007/s00264-018-4216-0

Cited by 16 publications

(19 citation statements)

References 25 publications

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“…Good functional, clinical, and radiographic outcomes as well as a reported survivorship of almost 90% at 5 years and more than 70% at 10 years have made the LOW distal femoral osteotomy (DFO) an attractive technique for the treatment of symptomatic valgus deformity [ 2 , 3 , 6 , 7 , 17 , 34 ]. Encouraging clinical outcomes are supported by a recently published biomechanical study, which has demonstrated the unloading effect of the lateral compartment after LOW-DFO [ 37 ].…”

Section: Introductionmentioning

confidence: 99%

A hinge position distal to the adductor tubercle minimizes the risk of hinge fractures in lateral open wedge distal femoral osteotomy

Winkler

Rupp

Lutz

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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Purpose To evaluate the incidence and morphology of medial cortical hinge fractures in lateral open wedge distal femoral osteotomy (LOW-DFO) and to determine a safe zone for the position of the osteotomy hinge to minimize the risk of hinge fractures. Methods Consecutive patients who underwent LOW-DFO for symptomatic valgus malalignment were screened for eligibility for this retrospective observational cohort study. Demographical and surgical data were collected. The incidence and morphology of medial cortical hinge fractures were evaluated on standard postoperative anterior–posterior knee radiographs. Comprehensive measurements evaluating the osteotomy gap and the position of the osteotomy hinge were taken. Additionally, each osteotomy hinge was assigned to a corresponding sector of a proposed five-sector grid of the distal medial femur. Results A total of 100 patients (60% female) with a mean age of 31 ± 13 years were included. The overall incidence of medial cortical hinge fractures was 46% and three distinct fracture types were identified. The most frequently observed fracture type was extension of the osteotomy gap (76%), followed by a proximal (20%) and distal (4%) course of the fracture line in relation to the hinge. Group comparison (hinge fracture vs. no hinge fracture) showed statistically significant higher values for the height of the osteotomy gap (p = 0.001), the wedge angle (p = 0.036), and the vertical distance between the hinge and the proximal margin of the adductor tubercle (AT; p = 0.002) in the hinge fracture group. Furthermore, a significantly lower horizontal distance between the hinge and the medial cortical bone (p = 0.036) was observed in the hinge fracture group. A statistically significant higher incidence of medial cortical hinge fractures was observed when the position of the osteotomy hinge was proximal compared to distal to the proximal margin of the AT (53% vs. 27%; p = 0.023). Conclusion Medial cortical hinge fractures in LOW-DFO are a common finding with three distinct fracture types. To minimize the risk of medial cortical hinge fractures, it is recommended to aim for a position of the osteotomy hinge at the level of or distal to the proximal margin of the adductor tubercle. Level of evidence Prognostic study; Level III

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Section: Introductionmentioning

confidence: 99%

A hinge position distal to the adductor tubercle minimizes the risk of hinge fractures in lateral open wedge distal femoral osteotomy

Winkler

Rupp

Lutz

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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“…Stahelin 26 recommended an oblique osteotomy as it provides large surface area and inherent stability. Majority favour uniplanar osteotomy 2,17,24,27 without increased incidence of nonunion. We prefer uniplanar osteotomy and use an external fixator to control the closure of medial wedge.…”

Section: Single Plane Vs Biplanar Osteotomymentioning

confidence: 99%

Osteotomies for lateral compartment knee osteoarthritis

Lahoti

Bansal

2022

Journal of Clinical Orthopaedics and Trauma

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Lateral compartment osteoarthritis (LCOA) is often associated with valgus deformity of the knee. The concept of correcting the alignment by performing distal femoral varus osteotomy (DFVO) to unload the lateral compartment is well accepted and it is viewed as the preferred option for young active patients due to dissatisfaction from arthroplasty under 55 years of age or if they wish to remain active. Beyond this there is no consensus on patient selection, preoperative assessment, techniques to achieve correction, end point of correction, return to work or sports post-surgery, and survivorship of osteotomy with conversion to a total knee replacement as the end point due to heterogenous, retrospective studies. Here, we review relevant literature to help patient selection, preoperative work up, techniques, and outcomes.

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“…Für die Patellastabilität ist vor allem eine valgische Beinachse ungünstig. Befindet sich der Ursprung dieser Deformität kniegelenknah, ist sie häufig mit einem verminderten mechanischen lateralen distalen Femurwinkel (mLDFA) verbunden [22]. Aus dieser Überlegung heraus kann eine Indikation zur Beinachsenkorrektur ab ca.…”

Section: Ganzbeinröntgenaufnahmeunclassified

Behandlung der Patellainstabilität

Kolb¹,

Willegger²,

Chiari³

et al. 2021

Z Orthop Unfall

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Die Patellainstabilität ist für die PatientenInnen eine belastende Erkrankung mit einer in der orthopädischen Praxis häufig auftretenden Problemstellung. Die Anomalien des patellofemoralen Gelenks, die die Stabilität des Kniescheibenlaufs beeinträchtigen können, sind vielfältig, sodass für eine erfolgreiche Therapie eine strukturierte Analyse essenziell ist. Dieser Beitrag zeigt den Aufbau einer differenzierten Diagnostik und Therapie sowie Beispiele aus der Praxis.

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Distal femoral varus osteotomy: results of the lateral open-wedge technique without bone grafting

Cited by 16 publications

References 25 publications

A hinge position distal to the adductor tubercle minimizes the risk of hinge fractures in lateral open wedge distal femoral osteotomy

A hinge position distal to the adductor tubercle minimizes the risk of hinge fractures in lateral open wedge distal femoral osteotomy

Osteotomies for lateral compartment knee osteoarthritis

Behandlung der Patellainstabilität

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