Midterm results following medial closed wedge distal femoral osteotomy stabilized with a locking internal fixation device

Forkel, Philipp; Achtnich, Andrea; Metzlaff, Sebastian; Zantop, Thore; Petersen, Wolf

doi:10.1007/s00167-014-2953-1

Cited by 56 publications

(66 citation statements)

References 37 publications

(83 reference statements)

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“…They compared the failed-group and the nonfailed one, and they stated that in the failed group, the average age was significantly higher [38]. On the other hand, Forkel et al analyzed different variables potentially correlated with the outcome of DFO; they found that neither age nor presence of associated microfractures affected the result [39]. Afterward, different authors described their results with slight modification of the original surgical technique.…”

Section: Medial Closing Wedgementioning

confidence: 99%

Distal femoral osteotomy

Rosso¹,

Margheritini

2014

Curr Rev Musculoskelet Med

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Osteotomies around the knee are well-recognized treatments for unloading the affected compartment in cases of lower limb malalignment. There are few papers in the literature describing the outcomes of distal femoral osteotomy (DFO), as compared with the studies reporting on high tibial osteotomy (HTO), probably because valgus malalignment is less common than the varus one. There is still debate as to what the correct indication is and which surgical techniques lead to the best outcomes in performing a DFO. Besides, it is still controversial whether patellofemoral arthritis should be considered as a contraindication to performing a DFO, as well as in HTO. In this article, we will summarize the indications for DFO, the surgical techniques reported in the literature, and their outcomes.

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Section: Medial Closing Wedgementioning

confidence: 99%

Distal femoral osteotomy

Rosso¹,

Margheritini

2014

Curr Rev Musculoskelet Med

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“…The authors concluded that overcorrecting the osteotomy of 5° normalize contact pressure and contact areas in the lateral compartment (23). Similarly, others authors reported good clinical outcomes with valgus deformity over-correction (mechanical axis goal at 40-41% of tibial plateau) due to lateral compartment unloading and medial muscles' forces neutralization (20,24).…”

Section: Preoperative Settingmentioning

confidence: 92%

“…Recently Forkel et al (24) described their surgical technique: bone cuts were performed at the same way described by Healy et al (27) but the osteotomies were fixed with locking plates. This fixation may increase the stability of the osteotomy and reduce the time of post-operative weight bearing limitation (13,24).…”

Section: Medial Closing-wedge Osteotomymentioning

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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“…Contraindications to the procedure include inflammatory arthritis, flexion contracture of greater than 15 , knee flexion of less than 90 , fixed valgus deformity of greater than 20 , and arthritis in the medial or patellofemoral compartments. 1,7,9 Patient Positioning and Anesthesia…”

Section: Varus-producing Dfo Indicationsmentioning

confidence: 99%

“…[2][3][4] Recently, the indications for varus-producing DFOs have expanded to include the treatment of valgus malalignment in the setting of central or medial ligamentous instability or incompetence. [5][6][7][8][9][10][11][12][13][14] This is of particular importance and utility because several authors have also reported that healing of both the native and reconstructed medial collateral ligament (MCL) is impaired with persistent valgus deformity at the knee. 6 For this reason, many surgeons now choose to perform a DFO to correct the valgus deformity at the knee not only in the setting of isolated lateral compartment pathology but also in the setting of medial ligamentous incompetence.…”

mentioning

confidence: 99%

Varus-Producing Lateral Distal Femoral Opening-Wedge Osteotomy

Mitchell

Dean

Chahla

et al. 2016

Arthroscopy Techniques

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Valgus knee alignment in excess of physiological valgus leads to excessive loading of the lateral compartment, which can potentially increase the risk of osteoarthritis and can place the medial knee structures at risk of chronic attenuation. Varus-producing distal femoral osteotomies have been proposed for correction of valgus malalignment, to relieve tension on medial-sided structures, as well as to off-load the lateral compartment. Understanding that symptomatic valgus deformity of the knee represents a complex problem that is magnified in the setting of lateral compartment arthritis or medial ligamentous incompetence, we present our preferred technique for a varus-producing distal femoral osteotomy using plate osteosynthesis and cancellous bone allograft.

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Midterm results following medial closed wedge distal femoral osteotomy stabilized with a locking internal fixation device

Abstract: IV.

Cited by 56 publications

References 37 publications

Distal femoral osteotomy

Distal femoral osteotomy

Femoral osteotomies for the valgus knee

Varus-Producing Lateral Distal Femoral Opening-Wedge Osteotomy

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