Open Wedge Distal Femoral Osteotomy: Accuracy of Correction and Patient Outcomes

Elattar, Osama; Swarup, Ishaan; Lam, Aaron; Nguyen, Joseph; Fragomen, Austin T.; Rozbruch, S. Robert

doi:10.1007/s11420-016-9516-6

Cited by 29 publications

(30 citation statements)

References 19 publications

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“…In summary, the clinical results of our cohort are comparable to those studies, who reported reliable results on LOWDFO [5–7, 16]. As a difference to former studies, our cohort includes especially younger patients as discussed above (for example Elattar at al.…”

Section: Discussionsupporting

confidence: 85%

“…As a difference to former studies, our cohort includes especially younger patients as discussed above (for example Elattar at al. (range 22 to 72 years) [7], Jacobi at al. (46 + −3.1 years) [4], Dewilde et al (range 30 to 51 years) [16], and Saithna et al (range 28 to 58 years) [6]).…”

Section: Discussionmentioning

confidence: 99%

“…has reported unfavourable results [4] due to complications like local tissue irritation and delayed bone healing. Most reports on lateral opening wedge distal femoral osteotomy are based on a technique including bone grafting of the opening wedge osteotomy [4, 5, 7, 16]. Here, with the exception of Jacobi et al who reported a non-union rate of 7.1%, a reliable low rate of non-unions (0 to 3%) was reported [5, 16].…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, the open-wedge technique is broadly used for the tibial correction of varus deformities [3], while the femoral open-wedge technique was discussed as being controversial. Basically, reports on specific implants used for the lateral opening wedge distal femoral osteotomy like the Tomofix plate (Synthes GmbH, Oberdorf, Switzerland) are rare, relied on different techniques of bone grafting, and have reported controversial results [4–7].…”

Section: Introductionmentioning

confidence: 99%

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

Kolb

Isak

Hobusch

et al. 2018

International Orthopaedics (SICOT)

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BackgroundThe lateral opening wedge distal femoral osteotomy (LOWDFO) to reconstruct knee alignment in patients with genu valgum originating in the distal femur has gained importance within the last years.PurposeTo analyze clinical and radiographic outcome of patients treated with LOWDFO with respect to bone healing without grafting and patient age.Material and methodsTwenty-two consecutive patients with genu valgum corrected with 23 LOWDFOs using a Tomofix-locking plate were retrospectively analyzed (mean age 23.7 years). Clinical evaluation was based on pre- and post-operative KOOS scores. A pre- and post-operative radiographic assessment, including MAD, mLDFA, LLD, bone healing, and patella parameters, was performed. Differences between subgroups (age, bone grafting) were analyzed.ResultsThe restoration of MAD and mLDFA resulted in significantly improved post-operative KOOS5 scores in younger and older patients (p = 0.001). Bone healing without bone grafting was reliable in all patients. The leg length was significantly increased post-operatively (p = 0.001). The Blackburne-Peel ratio was significantly reduced to more normal values post-operatively (p < 0.001).ConclusionLOWDFO without bone grafting is a reliable procedure representing a promising treatment option particularly in young patients with genu valgum. Besides correction of the MAD, a significant leg length increase and additional patella stability can be expected.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Kolb

Isak

Hobusch

et al. 2018

International Orthopaedics (SICOT)

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“…One of the problems of close‐wedge osteotomy is the accuracy of correction. The surgeon is very reliant on the preoperative plan for the accuracy of bony resection; even so, precise resection of a wedge is technically difficult during surgery. Besides, shortening of the limb will increase with the enlargement of the correction angle.…”

Section: Discussionmentioning

confidence: 99%

Medial Open‐wedge Osteotomy with Double‐plate Fixation for Varus Malunion of the Distal Femur

Wang

Sun

et al. 2019

Orthopaedic Surgery

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Objective To present our clinical experience of treating varus malunion of the distal femur through a medial open‐wedge osteotomy with double‐plate fixation. Methods A prospective cohort study was performed. From January 2005 to February 2015, 15 consecutive patients with varus malunion following distal femur fractures were surgically treated at a single level I trauma center. The coronal and sagittal deformity were corrected by a medial open‐wedge osteotomy of the distal femur. A medial buttress plate was used to maintain the realignment. A lateral locking plate was additionally used as a protection plate. The mean age of patients at the time of the surgery was 35.5 years (range, 22–58 years). The radiographical evaluation included the mechanical femorotibial angle, the mechanical lateral distal femoral angle, the anatomic posterior distal femoral angle, and the leg length discrepancy. Clinical outcome evaluation consisted of the range of motion (ROM) and Hospital for Special Surgery (HSS) score. Results Mean follow‐up was 7.4 years (range, 4–11.5 years). Varus and flexion malalignment and limb discrepancy were adequately corrected in all patients. The mechanical femorotibial angle, the mechanical lateral distal femoral angle, and the anatomic posterior distal femoral angle were restored from 17.5° (range, 13°–25°) to 2.3° (range, − 2°–7°), 102.3° (range, 95°–112°) to 85.2° (range, 81°–92°), and 77.1° (range, 65°–87°) to 82.7° (range, 76°–88°), respectively. The leg length discrepancy was diminished from 3.4 cm (range, 2.4–4.5 cm) to 0.8 cm (range, 0–1.7 cm). The average bone healing time was 4.1 months (range, 2.5–6 months). The average ROM of the affected knees at 24‐month follow‐up was 3.4°–112.55°. The score of HSS at 4‐years follow‐up was 76.1 (range, 64–88). No internal fixation failure or secondary operation was noted until the last follow‐up. Conclusion Medial open‐wedge osteotomy can adequately correct the posttraumatic varus malunion of the distal femur. With fixation of the double plate, non‐displaced bone healing and good functional outcome are expected.

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Osteotomy for the Valgus Knee in Cartilage Surgery

Hansom

Clatworthy

2021

Cartilage Injury of the Knee

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Open Wedge Distal Femoral Osteotomy: Accuracy of Correction and Patient Outcomes

Cited by 29 publications

References 19 publications

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

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

Medial Open‐wedge Osteotomy with Double‐plate Fixation for Varus Malunion of the Distal Femur

Osteotomy for the Valgus Knee in Cartilage Surgery

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