Lateral Opening-wedge Distal Femoral Osteotomy: Pain Relief, Functional Improvement, and Survivorship at 5 Years

Cameron, James I.; McCauley, Julie C.; Kermanshahi, Arash Y.; Bugbee, William D.

doi:10.1007/s11999-014-4106-8

Cited by 90 publications

(101 citation statements)

References 20 publications

(44 reference statements)

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“…Specifically, this article documented a 3% nonunion rate with no delayed unions [1], which is significantly less than a prior study suggested [3]. This nonunion occurred in the arthrosis subgroup and was ultimately treated with conversion to TKA.…”

mentioning

confidence: 67%

“…However, the lateral opening-wedge distal femoral osteotomy may have advantages including a single osteotomy cut, possible reduced neurovascular risk, and improved correction control due to increased flexibility during intraoperative corrective degree adjustments. Other questions exist including: (1) What are the specific indications and subsequent outcomes of the varus-producing distal femoral osteotomy for joint restoration and valgus gonarthrosis? (2) Which distal femoral osteotomy technique (lateral opening-wedge versus medial closing-wedge) may optimize these outcomes?…”

mentioning

confidence: 99%

“…The data by Cameron et al [1] aids in addressing the first question regarding which population is most effectively treated with distal femoral osteotomy by documenting that good clinical outcomes can be obtained following a lateral opening-wedge distal femoral osteotomy-particularly in patients in whom concomitant joint restoration procedures are utilized. I would like to congratulate these authors on stratifying the two separate populations, as this represents a crucial contribution in recognizing these distinctly different patient populations and provides preliminary data that may aid in answering this initial question.…”

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confidence: 99%

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CORR Insights®: Lateral Opening-wedge Distal Femoral Osteotomy: Pain Relief, Functional Improvement, and Survivorship at 5 Years

Maak

2015

Clinical Orthopaedics &Amp; Related Research

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confidence: 67%

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confidence: 99%

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confidence: 99%

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CORR Insights®: Lateral Opening-wedge Distal Femoral Osteotomy: Pain Relief, Functional Improvement, and Survivorship at 5 Years

Maak

2015

Clinical Orthopaedics &Amp; Related Research

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“…The available literature regarding DFO is limited and heterogeneous, but good clinical outcomes have been reported in different studies (8)(9)(10)(11). However, there are still some debated issues, such as the best surgical technique (closing or opening-wedge osteotomy), the type of fixation, the amount of correction to achieve, and the need for a biological graft to fill the osteotomy gap (7).…”

Section: Roberto Rossimentioning

confidence: 99%

“…Cameron et al compared outcomes of simple DFO and DFO associated with joint preservation techniques (osteochondral allograft transplantation and/ or meniscal allograft transplantation) and demonstrated a higher survivorship in the second group (five-years survivorship: 74% in the arthritis group and 92% in the joint preservation group) (10).…”

Section: Indications and Contraindicationsmentioning

confidence: 99%

Femoral osteotomies for the valgus knee

Olivero¹,

Rosso²,

Dettoni³

et al. 2017

Ann. Joint

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Coronal limb malalignment is an important contributing factor to articular cartilage damage and to the development of knee osteoarthritis. Osteotomies around the knee are effective and well-recognized treatments for unloading the affected compartment. Valgus malalignment is less common than varus malalignment. Consequently, distal Femoral Osteotomies to correct the valgus knee are less commonly performed compared to high tibial osteotomy (HTO) for the varus knee. There are few papers describing the outcomes of distal femoral osteotomy (DFO) to treat valgus knee alignment and knee arthritis. In literature, there is still an open debate about the correct indication and contraindication, the best surgical technique (opening versus closing wedge), the amount of correction to achieve and the use of bone grafts to enhance osteotomies healing. However, with the correct indications, Distal Femoral Osteotomies showed good outcomes in the treatment of valgus knee. The aim of this manuscript is to review the literature about DFO in the valgus knee, summarizing the indications and contraindications, the available surgical techniques, outcomes, complications and failure rates.

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Deformity in valgus knee malalignment is not only in the femur but also in tibia or both, based on demographic and morphological analysis before and after knee osteotomies

An,

Jacquet,

Loddo

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThis study aims to identify the demographic and morphological features of valgus knee deformity with unilateral osteoarthritic knee in the coronal plane. A secondary aim was to identify the distinct phenotypes of valgus knees in Hirschmann's phenotype and the coronal plane alignment of the knee (CPAK) classifications before and after a knee osteotomy (KO).MethodsA total of 107 patients (57 female and 50 male) with a mean age of 42.4 ± 17.2 years, who underwent varisation osteotomy for symptomatic unilateral knee osteoarthritis (OA) and constitutional valgus deformity, were enrolled in the study, and the mean follow‐up period was 29.1 ± 7.3 months. The included cases comprised 60 cases of distal femoral osteotomy, 10 cases of double‐level osteotomy and 33 cases of high tibial osteotomy. All patients underwent preoperative and postoperative clinical, functional and radiological evaluations, analysed by analysis of variance tests.ResultsAn analysis of the location of the valgus deformities demonstrated that 56 cases (52.3%) were femoral based, 18 cases (16.8%) were both femoral and tibial based and 33 cases (30.9%) were tibial based. Twelve preosteotomy cases (11.2%) and 38 postosteotomy cases (35.5%) matched the most common eight Hirschmann's phenotypes, phenotyping the coronal lower limb alignment based on the native alignment in young patients without OA. Four (3.7%) preosteotomy cases and 89 postosteotomy cases (83.1%) matched the most common three CPAK phenotypes (Ⅰ, Ⅱ, Ⅴ) based on constitutional alignment and joint line obliquity in healthy and osteoarthritic knees.ConclusionIn valgus knee malalignment, the location of the deformity is not only solely femoral‐based but also solely tibial‐based or combined femoral and tibial‐based. An individualised osteotomy approach would be recommended to achieve careful preoperative planning that considers the location of the deformity and the resultant joint line. Hirschmann's and CPAK classification would not be relevant when KO is considered.Level of EvidenceLevel Ⅳ, retrospective case–control study.

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Lateral Opening-wedge Distal Femoral Osteotomy: Pain Relief, Functional Improvement, and Survivorship at 5 Years

Cited by 90 publications

References 20 publications

CORR Insights®: Lateral Opening-wedge Distal Femoral Osteotomy: Pain Relief, Functional Improvement, and Survivorship at 5 Years

CORR Insights®: Lateral Opening-wedge Distal Femoral Osteotomy: Pain Relief, Functional Improvement, and Survivorship at 5 Years

Femoral osteotomies for the valgus knee

Deformity in valgus knee malalignment is not only in the femur but also in tibia or both, based on demographic and morphological analysis before and after knee osteotomies

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