Osteotomias femorais distais com cunha de fechamento medial—estudo retrospectivo

Cabral, Pedro Barreira; Astur, Diego Costa; Freitas, Eduardo Vasconcelos de; Pavei, Bruno Silveira; Kaleka, Camila Cohen; Cohen, Moisés

doi:10.1016/j.rbo.2017.10.007

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Rev Bras Ortop

2019

DOI: 10.1016/j.rbo.2017.10.007

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Osteotomias femorais distais com cunha de fechamento medial—estudo retrospectivo

Pedro Barreira Cabral¹,

Diego Costa Astur

Eduardo Vasconcelos de Freitas³

et al.

Abstract: Resumo Objetivo Descrever a técnica cirúrgica da osteotomia femoral com cunha de fechamento medial e uma série de casos submetidos a essa técnica. Métodos Foram avaliados 26 pacientes submetidos a osteotomia femoral distal com cunha de fechamento medial de 2002 a 2013. Os prontuários e exames de imagem de todos os pacientes foram revisados para avaliação do grau de correção e estado atual. Resultados Dos 26 pacientes operados, 12 eram do sexo masculino e 14 do feminino. A idade mé… Show more

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2022

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Computer‐aided Design of Distal Femoral Osteotomy for the Valgus Knee and Effect of Correction Angle on Joint Loading by Finite Element Analysis

Jin

Zhao

et al. 2022

Orthopaedic Surgery

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Objective Lateral open‐wedge distal femoral osteotomy (DFO) has been used to treat valgus deformity of the knee, with good clinical outcomes. However, there is a lack of biomechanical studies regarding the angle of correction. The objective of this study was to apply computer‐aided design (CAD) for osteotomy planning in a three‐dimensional (3D) anatomical model and to assess the biomechanical differences among the varying correction angles on joint loading by finite element analysis (FEA). Methods To model different angles of lateral open‐wedge DFO correction, the CAD software package Mimics 21.0 was used to accurately simulate the operated knee. The femur was cut to 0°, 2°, 4°, 6°, 8°, and 10° of varus (equivalent to hip‐knee‐ankle angles of 180°, 178°, 176°, 174°, 172°, and 170°, respectively). The original knee model and the corrected models were processed by FE software. Then, the FE models were subjected to an axial force to obtain the von Mises stress (VMS) and shear stress distributions within the femoral cartilages and menisci. Results Under a compressive load of 740 N, the highest VMS in lateral and medial compartments of the intact knee model was 3.418 and 3.303 MPa. The maximum value of both the VMS and the shear stress in the lateral compartment decreased as the varus angle increased, but the corresponding values in the medial compartment increased. When the hip‐knee‐ankle (HKA) angle was 180°, the VMS in the lateral and medial compartments was balanced (3.418 and 3.303 MPa, respectively). Meanwhile, when the HKA angle was 178° (3.488 and 3.625 MPa, respectively), the shear stress in the lateral and medial compartments was balanced. In addition, the magnitude of change in the stress was significantly higher in the medial compartment (90.9%) than in the lateral compartment (19.3%). Conclusion The optimal correction angle of the valgus knee is close to neutral alignment or slightly varus (0° ‐ 2°). Overcorrection is not recommended, as it can result in a steep increase of the stress within the medial compartment and may accelerate the process of medial compartment OA.

show abstract

Computer‐aided Design of Distal Femoral Osteotomy for the Valgus Knee and Effect of Correction Angle on Joint Loading by Finite Element Analysis

Jin

Zhao

et al. 2022

Orthopaedic Surgery

View full text Add to dashboard Cite

show abstract

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Osteotomias femorais distais com cunha de fechamento medial—estudo retrospectivo

Cited by 1 publication

References 12 publications

Computer‐aided Design of Distal Femoral Osteotomy for the Valgus Knee and Effect of Correction Angle on Joint Loading by Finite Element Analysis

Computer‐aided Design of Distal Femoral Osteotomy for the Valgus Knee and Effect of Correction Angle on Joint Loading by Finite Element Analysis

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