Distal Femoral Varusing for Osteoarthritis of Valgus Knee: A Long-Term Follow-Up

Abstract

Objective: Assess the long-term results of distal femoral varusing osteotomy and try to establish predictive criteria that could help on selecting patients to be submitted to this technique. Methods: Fifteen patients with lateral compartment osteoarthritis and valgus deformity of the knee were submitted to distal femoral “V” varusing osteotomy fixated with lateral plate, pursuing knee alignment at 0° on the anatomical axis. The mean follow-up period was 81.4 months, ranging from 43 to 132 months. The Knee Society Rating System protocol was employed. Additional assessed variables were the following: patient age, follow-up time, and postoperative anatomical angle. Results: 11 results were regarded as excellent or good (73%) and four as fair or poor (27%). Conclusion: Distal femoral “V” varusing osteotomy constitutes a good treatment alternative for patients with lateral compartment osteoarthritis and valgus knee. The following variables have not been confirmed: patient age at the time of surgery, follow-up time, and postoperative anatomical angle as predictive factors for the results.

Physical activity after distal femur osteotomy for the treatment of lateral compartment knee osteoarthritis

“…Direct comparison of the results of the present study with those reported above is not possible owing to distinct differences in the surgical methodologies employed. The surgical technique described in the present paper was different from those reported previously [1–7, 13, 30]. The apex of the V‐shaped osteotomy was proximal, in metaphyseal area, allowing greater contact area, stability and speed of healing.…”

“…Success rates for DFO procedures, V‐shaped with distal apex, have been reported by a number of researches including Aglietti et al [2] (14 patients; 71.4 % success rate; mean follow‐up time 21.8 months) and Aglietti and Menchetti (17 patients; success rate 76.4 %; mean follow‐up time 108 months) [1]. In addition, Andrade et al [4] reported satisfactory results for 73 % of DFO patients who had been followed‐up for 81.4 months, and emphasized that there was no deterioration in the status of these individuals during the follow‐up. However, prospective comparative studies are needed to determine the best surgical option and its relation to the physical and functional outcome.…”

“…Osteoarthritis of the knee commonly presents as varus deformity [1–6, 13, 14], while valgus deformity is more frequent in patients suffering from rheumatoid arthritis, renal osteodystrophy, osteocartilaginous and metabolic diseases or sequel of poliomyelitis [8–11]. High tibial osteotomy (HTO) is a well‐established and effective procedure for the treatment of pain and varus deformity, however, HTO is not recommended for the treatment of lateral compartment osteoarthritis of the knee, especially when femoral valgus deformity exceeds 12° and joint line obliquity is greater than 10° [8, 13, 15, 25, 26].…”