Varus-Producing Lateral Distal Femoral Opening-Wedge Osteotomy

Mitchell, Justin J.; Dean, Chase S.; Chahla, Jorge; Moatshe, Gilbert; Cram, Tyler R.; LaPrade, Robert F.

doi:10.1016/j.eats.2016.03.009

Cited by 29 publications

(12 citation statements)

References 22 publications

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“…The DFVO procedure was performed through a lateral approach using the technique previously described by Harris et al 5 The degree of correction was determined by calculating the angle between a line extending from the center of the femoral head to the center of the medial tibial spine and a line from the center of the talus through the center of the tibia. 24 The goal of realignment was to place the weight-bearing line at the medial tibial spine. A lowprofile titanium locking plate (Femoral Opening Wedge Osteotomy Plate; Arthrex, Naples, FL) with 4.5-mm threaded cortical screws was used proximally, and 6.5-mm cancellous screws were used for stable fixation.…”

Section: Surgical Techniquementioning

confidence: 99%

Return to Sport and Outcomes After Concomitant Lateral Meniscal Allograft Transplant and Distal Femoral Varus Osteotomy

Puzzitiello

Liu

Garcia³

et al. 2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Section: Surgical Techniquementioning

confidence: 99%

Return to Sport and Outcomes After Concomitant Lateral Meniscal Allograft Transplant and Distal Femoral Varus Osteotomy

Puzzitiello

Liu

Garcia³

et al. 2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…The technique utilized for DFVO has previously been described by Mitchell et al 13 The angle formed between a line through the center of the femoral head and the center of the tibial spine and a line passing from the talus through the center of the tibia was measured on the preoperative imaging. The degrees of correction necessary to have the weightbearing line fall over the medial tibial spine were then calculated.…”

Section: Surgical Techniquementioning

confidence: 99%

“…This procedure is commonly performed in combination with other procedures, such as meniscal allograft transplantation (MAT), to address pathologies that might otherwise cause recurrent symptoms. 8,18 The outcomes of this procedure have been relatively positive, 3,11,13 notably providing a mean survival rate of 80% at 10 years, thus being a viable treatment for delaying or reducing the need for knee arthroplasty. 3 In addition, DFVO for symptomatic valgus malalignment has the advantage of no permanent activity restrictions such as those with total knee arthroplasty (TKA), in which modifying activity is paramount to ensure prosthesis durability.…”

mentioning

confidence: 99%

Return to Work After Distal Femoral Varus Osteotomy

Puzzitiello

Liu

Garcia

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Distal femoral varus osteotomy (DFVO) is a well-described procedure to address valgus deformity of the knee. There is a paucity of information available regarding patients’ ability to return to work (RTW) after DFVO. Purpose: To report the objective findings for RTW rates and times for patients receiving a DFVO for lateral compartment osteoarthritis secondary to valgus deformity of the knee. Study Design: Cohort study; Level of evidence, 3. Methods: This was a retrospective study of patients who received a lateral-wedge opening DFVO. Patients must have worked within 3 years before their operation to be included for analysis. Patients were contacted at a minimum of 2 years postoperatively for interview and questionnaire evaluation, including a subjective work questionnaire, visual analog scale (VAS) for pain, Single Assessment Numerical Evaluation (SANE), and a satisfaction questionnaire. Results: Overall, 32 patients were contacted at a mean follow-up of 7.1 ± 4.1 years (range, 2.2-13.3 years). The mean ± SD age at the time of surgery was 30.8 ± 8.8 years (range, 17.2-46.5 years), and 65.6% of patients were female. Eleven patients (34.4%) received a concomitant meniscal allograft transplant, and 12 (37.5%) received a cartilage grafting procedure. The average VAS pain score decreased significantly from 6.1 preoperatively to 3.2 postoperatively ( P = .03). All patients were able to RTW, at a mean time of 6.0 ± 13.2 months postoperatively (range, 0-72 months). When stratified by work intensity, the average time to return was 13.8, 3.1, 2.7, and 2.9 months for high, moderate, light, and sedentary occupations, respectively. There was no significant difference between these RTW times ( P = .16), although this analysis may have been limited by the small sample size. Four patients whose work was classified as heavy work (50%) and 3 whose work was classified as moderate work (18.8%) either switched jobs or kept the same job with lighter physical duties as a result of their procedures. Conclusion: In a young and active population, DFVO for valgus deformity reliably afforded the ability to RTW within a relatively short time for patients with sedentary, light, and moderate occupational demands. However, patients with moderate- to high-intensity occupational demands may be unable to RTW at their preoperative level.

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“…A lateral opening-wedge osteotomy effectively creates genu varum to offload the lateral compartment. 39 Studies show good outcomes with this technique, but most patients require conversion to TKA by 20 years. 64…”

Section: Meniscus Transplantationmentioning

confidence: 96%

Joint Preservation Techniques in Orthopaedic Surgery

et al. 2017

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Context:With increasing life expectancy, there is growing demand for preservation of native articular cartilage to delay joint arthroplasties, especially in younger, active patients. Damage to the hyaline cartilage of a joint has a limited intrinsic capacity to heal. This can lead to accelerated degeneration of the joint and early-onset osteoarthritis. Treatment in the past was limited, however, and surgical treatment options continue to evolve that may allow restoration of the natural biology of the articular cartilage. This article reviews the most current literature with regard to indications, techniques, and outcomes of these restorative procedures.Evidence Acquisition:MEDLINE and PubMed searches relevant to the topic were performed for articles published between 1995 and 2016. Older articles were used for historical reference. This paper places emphasis on evidence published within the past 5 years.Study Design:Clinical review.Level of Evidence:Level 4.Results:Autologous chondrocyte implantation and osteochondral allografts (OCAs) for the treatment of articular cartilage injury allow restoration of hyaline cartilage to the joint surface, which is advantageous over options such as microfracture, which heal with less favorable fibrocartilage. Studies show that these techniques are useful for larger chondral defects where there is no alternative. Additionally, meniscal transplantation can be a valuable isolated or adjunctive procedure to prolong the health of the articular surface.Conclusion:Newer techniques such as autologous chondrocyte implantation and OCAs may safely produce encouraging outcomes in joint preservation.

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Varus-Producing Lateral Distal Femoral Opening-Wedge Osteotomy

Cited by 29 publications

References 22 publications

Return to Sport and Outcomes After Concomitant Lateral Meniscal Allograft Transplant and Distal Femoral Varus Osteotomy

Return to Sport and Outcomes After Concomitant Lateral Meniscal Allograft Transplant and Distal Femoral Varus Osteotomy

Return to Work After Distal Femoral Varus Osteotomy

Joint Preservation Techniques in Orthopaedic Surgery

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