Medial closing-wedge distal femoral varus osteotomy: Symptoms and functional impact in cases of associated patellofemoral osteoarthritis. A two-year follow-up prospective pilot study

Distal femur varus-producing osteotomy: An updated review of patellofemoral implications and clinical outcomes

“…Only 3 studies 4,15,23 reported clinical data concerning pain on the VAS and a decrease from a mean preoperative value of 4.7 to 2.1 was observed. Kujala score was reported by 7 studies 4,14,15,16,17,19,23 reporting an average increase of 35.8 points from a preoperative mean value of 47.1 to 82.8 postoperatively. Only the study by Abdi et al 20 uses the IKDC and reports an improvement of 6 points from 65 to 71.…”

“…Akaoka et al 1 reported that medial closed-wedge DFO for the valgus knee does not adversely affect the patellofemoral joint. Few studies 17,19,20 shows that distal femoral varus osteotomy is a valid treatment to obtain a centralization of the trochlea and a medialization of the patella. Several studies 10,18,19,21 reported the postoperative clinical outcomes of the knee without, however, specifying the recurrence rate of patellar dislocation, highlighting an improvement in the clinical parameters taken into consideration.…”

“…Few studies 17,19,20 shows that distal femoral varus osteotomy is a valid treatment to obtain a centralization of the trochlea and a medialization of the patella. Several studies 10,18,19,21 reported the postoperative clinical outcomes of the knee without, however, specifying the recurrence rate of patellar dislocation, highlighting an improvement in the clinical parameters taken into consideration. Other studies have analyzed the recurrence rate of postoperative patellar dislocation: Frings et al, 4 Swarup et al, 15 and Yoshvin et al17 did not observe redislocation of patella after surgery while Wilson et al 16 reported that 80% of the treated patients have no further episode of instability.…”

“…Four studies were carried out to evaluate the clinical efficacy of the treatment: two of these studies 18,19 were carried out in young patients on non-arthritic knees, one study 15 was carried out to evaluate clinical efficacy and pain relief in arthritic knees, one study 13 instead considered a more heterogeneous cohort of patients. The aim of two studies 20,21 was to evaluate patellofemoral symptoms and the implication of femoropatellar osteoarthritis following DFO.…”

Osteotomies for lateral compartment knee osteoarthritis

“…Other studies have used Outerbridge grading 7 or mild to moderate grading and reported good results irrespective of severity of degenerative changes in the lateral compartment. Barnavon et al 18 have shown that the medial closing wedge DFVO has beneficial effect on co-existing patello-femoral osteoarthritis due to medialization of the patella and concluded that although patellofemoral osteoarthritis improvement was difficult to determine on its own due to lack of specificity of patellofemoral scores, PF OA does not represent a contraindication to DFVO. Although it is difficult to draw definitive conclusions from these heterogenous studies, advanced lateral compartment degeneration is not a contraindication for DFVO.…”