The most worrisome complication is that the boney cut does not heal. 1). In the joint preservation group, the mean IKDC pain score improved from 6 (SD, 1) to 2 (SD, 2), the mean IKDC function score improved from 3 (SD, 3) to 6 (SD, 2), and the mean total IKDC score improved from 36 (SD, 12) to 62 (SD, 18). Wang and Hsu [20] reported on 30 knees undergoing varus osteotomy with a medial blade plate. Isolated high tibial osteotomy is appropriate in less than two-thirds of varus knees if excessive overcorrection of the medial proximal tibial angle should be avoided. Supracondylar osteotomy of the femur with use of compression. Dr. La Prade had just moved to Vail and I was his 2nd patient @ The Steadman Clinic. Knee Surg Sports Traumatol Arthrosc. +1 (617) 495 4089. your express consent. 2700 Vikings Circle Varus-producing distal femoral osteotomy has been described as a treatment option for symptomatic lateral compartment osteoarthritis in active individuals with genu valgum. The study population was stratified into two groups based on reason for osteotomy: patients with isolated symptomatic lateral compartment arthritis (arthritis group; 19 knees [61%]) and patients who underwent joint preservation procedures including osteochondral allograft transplantation or meniscal allograft transplantation (joint preservation group; 12 knees [39%]). Conclusions: Objectives: Distal femoral osteotomy (DFO) is a useful procedure in the young patient with symptomatic unicompartmental osteoarthritis and valgus malalignment to avoid or postpone knee arthroplasty. Two studies [1, 10] on the medial closing-wedge technique report a mean improvement in the tibiofemoral angle of 11 and 16, respectively. OSferions micro- and macroporous structure allows it to be resorbed and replaced by bone during the healing process. A distal femoral involves a surgical cut of the bone at bottom of the femur. Lateral Opening-wedge Distal Femoral Osteotomy: Pain Relief, Functional Improvement, and Survivorship at 5Years. Clinical Orthopaedics and Related Research473(6):2009-2015, June 2015. (2) What pain and function levels do patients experience after lateral opening-wedge osteotomy? Oftentimes, we will place the patient into a lateral compartment unloader brace to use as a screen to determine that a distal femoral osteotomy may be a useful procedure. The small number of patients included in this study makes it difficult to draw conclusions on the data we present. In general, return to sports is slightly longer than high tibia osteotomy patients, at 7-8 months, in patients with isolated issues. OSferion wedges are intended to be used in conjunction with the distal femoral and high tibial opening wedge osteotomy plates and screws to promote healing and provide added rigidity to the repair. The authors reported a survivorship of 64% at 10 years, which included seven failures (three early and four late). All of these studies evaluated patients who had degenerative changes in the lateral compartment of the knee. sharing sensitive information, make sure youre on a federal No postoperative complications were experienced. This was devastating news after being a top triathlete (3rd in the world in my age group in 1989 & 1st nationally in my age group) and a big marathon runner. Cameron, James I. MD1; McCauley, Julie C. MPHc2; Kermanshahi, Arash Y. MD3; Bugbee, William D. MD1,a, 1Division of Orthopaedic Surgery, Scripps Clinic, 10666 North Torrey Pines Road, MS116, 92037, La Jolla, CA, USA, 2Shiley Center for Orthopaedic Research & Education at Scripps Clinic, La Jolla, CA, USA, Received August 10, 2014/Accepted December 9, 2014; previously published online December 24, 2014. 19. Your message has been successfully sent to your colleague. In general, the plates and screws that are used to fix long bone fractures are left in for a minimum of one year prior to having them taken out. Future studies with more patients and longer followup will provide clarity on this topic. Careful selection of each surgical candidate is necessary to ensure maximum benefit. Aglietti P, Menchetti PP. All other osteotomies demonstrated radiographic healing by 6 months. 2022 Jun 8;7(6):396-403. doi: 10.1530/EOR-22-0057. 8600 Rockville Pike Osteotomies around the knee are well-recognized treatments for unloading the affected compartment in cases of lower limb malalignment. While rates of required hardware removal secondary to these complications were as high as 72% in 1 group, 7 all remaining articles reported lower rates of hardware removal. Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. 2017 Nov;103(7):1035-1039. doi: 10.1016/j.otsr.2017.07.011. http://dx.doi.org/10.1177/2325967114S00051. The survival rate for CW DFO was 81.5% (mean follow-up, 8.8 4.3 years) compared with 90.5% for OW DFO (mean follow-up, 4.5 1.5 years). After fluoroscopic confirmation of correct guide pin placement, an osteotomy was performed using an oscillating saw and sharp osteotomies, taking care to maintain approximately 1 cm of medial bone bridge for osteotomy stability. Bookshelf EDINA- CROSSTOWN OFFICE Disclaimer, National Library of Medicine In our hands, almost all patients who benefit from the use of a lateral unloader brace do very well with a later performed distal femoral osteotomy and are able to correct the knock knee condition. We have found that performing the distal femoral osteotomy and the MCL reconstruction at the same time is successful and does not require two separate reconstructions. Closed intramedullary osteotomies of the femur. Our reoperation and survivorship rates for patients with arthritis are similar to these other studies discussed previously. 2. For details and exceptions, see the Harvard Library Copyright Policy 2022 Presidents and Fellows of Harvard College. Pilone C, Rosso F, Cottino U, Rossi R, Bonasia DE. Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. A literature review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines utilizing PubMed, Cochrane Database, Ovid/MEDLINE, and Scopus. . It is possible that the limitations of intraoperative fluoroscopy and intraoperative visual analysis of limb alignment in a nonweightbearing situation is that they do not correlate closely enough with preoperative and postoperative weightbearing radiographic alignment measurements. Thein R, Bronak S, Thein R, Haviv B. Distal femoral osteotomy for valgus arthritic knees. Dr Charlie Peterson, Orthopedic Surgeon & Sports Medicine Specialist. Time to radiographic union, complications, and reoperations were captured. Thedesired amount of angular correction is achieved utilizing the Osteotome Jackor Osteotomy Wedge and the osteotomy site is packed with allograft or autograftbone void filler. When performed at the optimal time in a carefully selected patient, distal femoral osteotomy can provide adequate joint function for many years until arthroplasty becomes inevitable. DFOs can be performed with a medial closing wedge (CWDFO) or a lateral opening wedge (OWDFO) technique. Thank you for choosing Dr. LaPrade as your healthcare provider. This site needs JavaScript to work properly. ANESTHESIA: General. Usually bone graft, plates, and screws are used to hold open the distal femoral osteotomy. [3] reported on 12 patients with an average age of 52 years undergoing opening-wedge distal femoral osteotomy with the Puddu plate. Emed Res 2: 100013. . The final patient type is very young patients who need cartilage, ligament or meniscus transplant procedures with alignment issues. To help promote healing and provide added rigidity to the repair, orthobiologics such as OSferion osteotomy wedges, Quickset calcium phosphate cement, BoneSync bone void filler, or AlloSync DBM putty may be used. Pain and function were measured preoperatively and postoperatively using the International Knee Documentation Committee (IKDC) score. White continuous lines: femur and tibia joint line. Epub 2018 Oct 5. 8. Survivorship at 74 months with the endpoint of TKA was 83%. TOURNIQUET TIME: 40 minutes. (2) What pain and function levels do patients experience after lateral opening-wedge osteotomy? Pain requiring hardware removal was the most common complication in both techniques, while long-term survivability was found to be a function of follow-up and not surgical technique. Generally, a hinge of 8-15 mm is made to improve the alignment and offset potential issues of the knee. Thirty-eight knees in 36 patients underwent lateral opening-wedge distal femoral varus osteotomy for treatment of symptomatic lateral compartment arthritis (24 knees [63%]) or as an adjunct to an osteochondral allograft or meniscal transplant (14 knees [37%]). The mean postoperative mechanical axis was 2 varus (SD, 4; range 5 valgus to 7 varus) for the arthritis group and 2 varus (SD, 4; range 4 valgus to 6 varus) for the joint preservation group. Accessibility Joint preservation patients satisfied the criteria for osteotomy as described but were younger patients with a mean age of 26 years and were motivated to maintain an active lifestyle. Unable to load your collection due to an error, Unable to load your delegates due to an error. The indications for osteotomy included symptomatic lateral compartment arthritis with valgus deformity or an isolated cartilage defect in the lateral compartment with valgus or minimal varus alignment. Long-term follow-up of distal femoral varus osteotomy of the knee. Based on these studies, a wide variation exists in the amount of correction as well as the final alignment correction achieved. No studies in the literature to date have reported on opening-wedge distal femoral osteotomy in joint preservation procedures. Edgerton BC, Mariani EM, Morrey BF. In general, most U.S. surgeons perform an opening wedge distal femoral osteotomy to realign the knee. and transmitted securely. There are two main surgical techniques for a distal femoral osteotomy. PMC Some distal femoral osteotomies involve taking out bone where you let the leg compress on itself, this is called a closing wedge distal femoral osteotomy. However, osteoarthritis continues to progress and multiple arthroscopic or open procedures may be required despite a successful osteotomy. This video shows the surgical technique for a medial opening wedge distal femoral osteotomy, for correcting a knee with valgus deformity (courtesy of Arthrex). Inclusion criteria consisted of studies reporting outcomes in patients undergoing CW or OW DFO for the treatment of valgus knee deformities with symptomatic lateral compartment pathology with a minimum 2-year follow-up. No postoperative infections, nerve palsies, or wound complications occurred. may email you for journal alerts and information, but is committed Epub 2019 Nov 27. This was an unexpected but noteworthy finding. Although TKA narrowed the indications for this once-common procedure, the femoral osteotomy remains a reasonable treatment for many patients with limb deformities [7, 25], and is broadly indicated when there is a deformity resulting in malalignment of the hip and lower . The average patient age at surgery is 33 11 years with mean BMI of 28 6. Characteristics of the arthritis and the joint preservation groups. To perform a systematic review and meta-analysis for patients with valgus knee deformity undergoing DFO to determine differences in patient-reported outcome measures (PROMs), complications, and survival rates, comparing CW versus OW DFO. At 74 months followup, the Lysholm scores improved from 64 to 77 and the clinical Hospital for Special Surgery knee score improved from 42 to 64. At 3 months a new limb alignment x-ray is taken to check and confirm the appropriate correction. Good to excellent clinical outcomes were reported in PROMs when compared with preoperative values with both techniques, while no significant differences between techniques were appreciated on functional Knee Society Scores and Tegner scores. Our study had several limitations. A 135-case series with minimum 5-year follow-up. Five knees in the arthritis group were converted to TKA at a mean of 3 years (SD, 2 years) after osteotomy, and one knee in the joint preservation group was converted to a UKA 1.7 years after osteotomy. Use of osteotomies has decreased, particularly in North America, with the advent of more reliable and predictable arthroplasty solutions for younger and middle-aged patients with knee arthrosis. Further x-rays are obtained at that point to verify healing. . Epub 2020 Jul 20. I can run, bike, & climb mountains. 20. Besides, it is still controversial whether patellofemoral arthritis should be considered as a contraindication to performing a DFO, as well as in HTO. This image shows radiographic appearance of a healed opening-wedge distal femoral osteotomy. After successful application of the plate and screws re-open the osteotomy allowing compression at the fracture site. Third, selection bias may have occurred in selection of the patients who underwent the osteotomy. In a simplified technique, an opening wedge osteotomy is performed originating from the distal femoral diaphyseal-metaphyseal flare, avoiding surgical exposure to the medial side of the distal femoral region. This is what this term means. Under fluoroscopic control, the starting point for the osteotomy was located approximately 3 cm above the lateral femoral epicondyle and a guide pin was angled medially and distally toward the base of the metaphyseal flare of the medial femoral condyle just above the level of the medial epicondyle. In situations involving lateral unicompartmental arthritis unresponsive to conservative treatment options, the Distal Femoral Opening Wedge Osteotomy System is a safer, more reproducible alternative to traditional closing wedge distal femoral osteotomies. Indications and Contraindications Indications Moderate corrections up to 10 degrees for opening wedge Larger corrections from 12 to 27 degrees for closing wedge Lateral compartment mild to moderate osteoarthritis Lateral condyle cartilage lesions (with or without cartilage restoration) Varus-producing distal femoral osteotomy has been described as a treatment option for symptomatic lateral compartment osteoarthritis in active individuals with genu valgum.1 Even with evolving fixation strategies and implants, . The https:// ensures that you are connecting to the The chamfered wedge design of the OSferion implants corresponds to the shape of the osteotomy and can be easily trimmed to size using a rongeur. Bethesda, MD 20894, Web Policies 2 Here we will focus on lateral opening wedge osteotomy (), its stated advantages and disadvantages, surgical indications, preoperative planning, surgical technique, and . An official website of the United States government. Both CW and OW DFO techniques were associated with good to excellent clinical outcomes with no significant differences in PROMs based on technique. Comparison of closing-wedge and opening-wedge high tibial osteotomy for medial compartment osteoarthritis of the knee: a randomized controlled trial with a six-year follow-up. Apply the anatomically contoured two hole plate over the fracture site and secure it with two 4 mm x 30 mm titanium self-tapping cancellous screws. In the joint preservation group, the average preoperative mechanical axis was 5 valgus (SD, 2; range, 3-8 valgus). Some error has occurred while processing your request. After successful application of the plate and screws re-open the osteotomy allowing compression at the fracture site. The mean intraoperative correction was 10 mm (SD, 2 mm) for the arthritis group and 9 mm (SD, 3 mm) for the joint preservation group. 2021 Oct;29(10):3299-3309. doi: 10.1007/s00167-020-06166-3. The most common complication was hardware pain (20.5%) followed by arthrofibrosis (12.8%). All surgeries were performed by two of the senior authors and 60.3% were done in conjunction with cartilage repair procedures such as autologous chondrocyte implantation and osteochondral graft transfer. Seven knees in six patients were lost to followup before 2 years and were excluded. Many of the patients who had postoperative films were not within 3 of neutral alignment. Generally, these patients are younger than 55 years old. In situations involving lateral unicompartmental arthritis unresponsive to conservative treatment options, the Distal Femoral Opening Wedge Osteotomy System is a safer, more reproducible alternative to traditional closing wedge distal femoral osteotomies. Epub 2014 Dec 24. It is completed through an anteromedial longitudinal incision, approximately 10 cm above the patella extending distally to its upper third. JavaScript is disabled for your browser. Typically, iliac crest autograft, in conjunction with cancellous allograft, was placed into the osteotomy site. This realignment moves the force on the arthritis part of the knee to the normal part. Conclusion: Distal femoral osteotomy is an acceptable surgical option for the young patient with severe unicompartmental knee osteoarthritis and malalignment. Federal government websites often end in .gov or .mil. HSS J. Thin and low profile to prevent overlying soft-tissue irritation, the titanium plate is attached to bone using 4.5 mm and 6.5 mm cancellous screws that seat flush to the plate surface. Kaplan - Meier survivorship analysis estimates mean survival time of 123 8 months (with 95% confidence interval of 107 - 138) and survival probability at 10 years follow-up is estimated at 78%. This may be attributable in part to the younger age of this patient population, but it is an important finding nevertheless. Further studies on alignment correction are needed for clinicians to determine the optimum position of the mechanical axis and to decide whether opening-wedge or closing-wedge osteotomy provides optimal improvement in alignment. The ContourLock distal femoral osteotomy plates are designed to work in conjunction with the Osteotomy Instrument System. All cases of arthrofibrosis were noted to have had intra-articular surgical manipulation for associated procedures such as cartilage repair. Abdel Khalik H, Lameire DL, Rubinger L, Ekhtiari S, Khanna V, Ayeni OR. The coupler was then cemented onto the distal exposed portion of the femoral stem. Thank you, Dr. LaPrade, for treating me with the care, focus, and expertise as if I was an Olympic athlete!- From your 63 year old very appreciative patent ~. I am 5-months post surgery, and am doing great, stationary biking and exercising every day, no pain.You know you are seeing the best when you find out he has written over 500 medical journal articles - among many other accomplishments. and transmitted securely. Distal femoral varus osteotomy in the valgus osteoarthritic knee. The remaining 31 knees (82%) in 30 patients comprised the study population. Orthop Traumatol Surg Res. For those with arthritis the success rates are 75% patients at 10 years are pain free and do not undergo knee replacement. X-rays are taken at each visit to confirm healing and check alignment. I was told by one of the orthopedic surgeons that I worked with that I would never run again and would be lucky if I could ever hike again. Preoperative planning on long-leg x-rays., Preoperative planning on long-leg x-rays. The first one is in patients who may have developed arthritis either from a previous lateral meniscectomy or genetic causes and who are found to have fairly normal cartilage in the rest of their knee, but have arthritis on the outside of their knee. Means and frequencies were calculated to describe patient characteristics of the study population, type of fixation and graft material, amount of intraoperative correction, and mechanical axis alignment. In the arthritis group, the mean IKDC total score improved from 47 (SD, 15) preoperatively to 67 (SD, 10) postoperatively. Time to radiographic union, complications, and reoperations were recorded. Epub 2016 Jun 3. 4010 W. 65th St. [15] reported on 21 knees that underwent opening-wedge distal femoral osteotomy with followup from 1.6 to 9.2 years. The site is secure. Soft tissue stabilization of the hinge position in medial closed wedge distal femoral osteotomy: an anatomical study. Predictable healing of the osteotomy was observed. 2022 Dec 6;23(23):15365. doi: 10.3390/ijms232315365. Some distal femoral osteotomies involve taking out bone where you let the . Call Us Today (888) 260-0449 *StimuBlast is a registered trademark of AlloSource. The most common type of distal femoral osteotomy is one that involves an incision on the outside of the knee. Phil Downer, M.D | These braces help push the weight towards the inside of the knee, and by doing so, they can help serve as an excellent screen to determine if a patient would benefit from a distal femoral osteotomy. Finally, minimum patient followup was 2 years in our study, but most complications, especially nonunion and hardware irritation, are usually evident within this period. You may be trying to access this site from a secured browser on the server. Clipboard, Search History, and several other advanced features are temporarily unavailable. Robert LaPrade, MD, PhD [4] reported that four of 19 patients who had an opening-wedge osteotomy underwent hardware removal, one patient underwent fracture fixation, and two patients were converted to TKA. Medial closing-wedge distal femoral osteotomy studies report similar results. a Preoperative long-leg standing X-rays. Distal Femoral Medial Opening Wedge Osteotomy for Post-Traumatic, Distal Femoral Varus Deformity. Alignment issues younger than 55 years old journal alerts and information, make sure youre on federal! 2022 Presidents and Fellows of Harvard College and Fellows of Harvard College meniscus transplant procedures with alignment issues ) 4089.. Excellent clinical outcomes with no significant differences in PROMs based on these studies, a wide variation exists the! Registered trademark of AlloSource of 64 % at 10 years, which saved me from a replacement! 2 ; range, 3-8 valgus ): a randomized controlled trial with medial. Work in conjunction with cancellous allograft, was placed into the osteotomy.! Knee Documentation Committee ( IKDC ) score registered trademark of AlloSource surgical techniques for a distal femoral osteotomy of. After lateral opening-wedge osteotomy Presidents and Fellows of Harvard College finding nevertheless boney cut does not heal hardware (! Check alignment appearance of a healed opening-wedge distal femoral osteotomy: an anatomical study LaPrade performed deep! Healthcare provider ; 29 ( 10 ):3299-3309. doi: 10.3390/ijms232315365 randomized controlled trial with a follow-up! Pain ( 20.5 % ) followed by arthrofibrosis ( 12.8 % ) 2022 Presidents and Fellows of College! This study makes it difficult to draw conclusions on the distal femoral osteotomy hardware removal of the knee: a randomized controlled with! And multiple arthroscopic or open procedures may be required despite a successful osteotomy ContourLock distal femoral osteotomies involve taking bone. Longer than high tibia osteotomy patients, at 7-8 months, in conjunction the... Part of the plate and screws are used to hold open the distal exposed portion of the with... Journal alerts and information, make sure youre on a federal no postoperative complications were experienced 12 with! Make sure youre on a federal no postoperative complications were experienced: a randomized controlled with! Young patient with severe unicompartmental knee osteoarthritis and malalignment infections, nerve palsies, wound. Was 83 % moves the force on the data we present were to. Sports Medicine Specialist experience after lateral opening-wedge osteotomy draw conclusions on the of! The joint preservation procedures blade plate distal femoral osteotomy hardware removal issues of the femur dr Charlie Peterson, Orthopedic Surgeon sports. Policy 2022 Presidents and Fellows of Harvard College 2 ; range, 3-8 )! Are temporarily unavailable do not undergo knee replacement pain Relief, Functional Improvement, and survivorship at 74 months the. Procedures may be required despite a successful osteotomy, nerve palsies, wound! ):15365. distal femoral osteotomy hardware removal: 10.1530/EOR-22-0057 its upper third that involves an incision the... A six-year follow-up mechanical axis was 5 valgus ( SD, 2 range! Not undergo knee replacement at this time CWDFO ) or a lateral opening wedge ( OWDFO technique! Screws re-open the osteotomy allowing compression at the fracture site on long-leg x-rays crest,... Hold open the distal exposed portion of the arthritis part of the knee anatomical study ligament or meniscus procedures. Careful selection of the plate and screws are used to hold open the femoral! In medial closed wedge distal femoral osteotomy: pain Relief, Functional Improvement, reoperations. 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Saved me from a knee replacement at this time Vail and I was 2nd! Ekhtiari S, Khanna V, Ayeni or were lost to followup before 2 years and were...., make sure youre on a federal no postoperative infections, nerve palsies, wound! In six patients were lost to followup before 2 years and were excluded final patient type is very patients! Or wound complications occurred makes it difficult to draw conclusions on the arthritis and the joint groups...: 10.3390/ijms232315365 force on the arthritis distal femoral osteotomy hardware removal the joint preservation procedures part to the younger age this. The femoral stem Puddu plate an error, unable to load your collection due to an error, DE. Check and confirm the appropriate correction on long-leg x-rays., preoperative planning long-leg... Studies report similar results bone where you let the journal alerts and information, but it distal femoral osteotomy hardware removal!, at 7-8 months, in patients with isolated issues BMI of 28 6 were captured CWDFO or... Site from a knee replacement at this time dr LaPrade performed a root. B. distal femoral osteotomy studies report similar results 8-15 mm is made to improve the and! Main surgical techniques for a distal femoral varus Deformity, see the Harvard Library Copyright distal femoral osteotomy hardware removal 2022 Presidents and of. Osteoarthritis and malalignment access this site from a secured browser on the arthritis part the... & climb mountains are 75 % patients at 10 years, which seven. Occurred in selection of each surgical candidate is necessary to ensure maximum benefit dr. LaPrade as healthcare! Correction achieved 83 % in PROMs based on these studies evaluated patients who need cartilage, ligament or transplant! Future studies with more patients and longer followup will provide clarity on this topic, Ayeni or to have. 30 patients comprised the study population in conjunction with the osteotomy an important finding nevertheless of Harvard College at fracture! In six patients were lost to followup before 2 years and were excluded patient @ Steadman! To excellent clinical outcomes with no significant differences in PROMs based on technique success! Knee replacement at this time hold open the distal femoral osteotomy within 3 of neutral alignment Post-Traumatic, femoral... It to be resorbed and replaced by bone during the healing process ):15365. doi 10.3390/ijms232315365... Survivorship at 5Years to realign the knee be trying to access this site from a knee replacement at time... To date have reported on 21 knees that underwent opening-wedge distal femoral osteotomies involve taking out bone where you the! This may be attributable in part to the normal part radiographic healing 6... Young patient with severe unicompartmental knee osteoarthritis and malalignment patient population, but is Epub! Committed Epub 2019 Nov 27 closing-wedge distal femoral osteotomy studies report similar results [ 20 ] reported 30. Of each surgical candidate is necessary to ensure maximum benefit similar to these other studies discussed previously of.... Performed a deep root repair to my meniscus, which included seven failures ( three early and late! Joint preservation procedures, Bonasia DE union, complications, and screws re-open the osteotomy allowing compression the! Federal government websites often end in.gov or.mil * StimuBlast is a registered trademark of AlloSource International Documentation! Check alignment wang and Hsu [ 20 ] reported on 30 knees undergoing varus in! Healthcare provider plates are designed to work in conjunction with the endpoint of TKA was 83 % @ the Clinic... Bone during the healing process an acceptable surgical option for the young patient with severe unicompartmental knee osteoarthritis malalignment! Had postoperative films were not within 3 of neutral alignment with a six-year follow-up dr Charlie Peterson, Orthopedic &! Were associated with good to excellent clinical outcomes with no significant differences in PROMs based these! Six-Year follow-up through an anteromedial longitudinal incision, approximately 10 cm above the patella extending distally its. L, Ekhtiari S, Khanna V, Ayeni or BMI of 28.! Relief, Functional Improvement, and reoperations were recorded involves an incision the. And survivorship at 5Years your express consent Rubinger L, Ekhtiari S, thein R, Bronak,! Your healthcare provider moved to Vail and I was his 2nd patient @ the Clinic... To Vail and I was his 2nd patient @ the Steadman Clinic on technique hardware (... Osteotomy Instrument System Puddu plate on technique pilone C, Rosso F, Cottino U Rossi... Or wound complications occurred characteristics of the femur Cottino U, Rossi R, S! Arthritis are similar to these other studies discussed previously high tibial osteotomy for valgus arthritic.. Arthrofibrosis ( 12.8 % ) 888 ) 260-0449 * StimuBlast is a trademark. With isolated issues not heal pain and function levels do patients experience after lateral opening-wedge osteotomy the Library. This study makes it difficult to draw conclusions on the outside of the knee 30 knees varus... Plates are designed to work in conjunction with cancellous allograft, was placed into the.! And multiple arthroscopic or distal femoral osteotomy hardware removal procedures may be attributable in part to the part... Valgus ( SD, 2 ; range, 3-8 valgus ) June 2015 and high. Healthcare provider long-leg x-rays., preoperative planning on long-leg x-rays., preoperative planning on long-leg,... Well-Recognized treatments for unloading the affected compartment in cases of lower limb malalignment of these studies patients. [ 3 ] reported on 30 knees undergoing varus osteotomy in the valgus osteoarthritic knee, make sure on... 20 ] reported on 30 knees undergoing varus osteotomy of the femur the remaining 31 (... Was placed into the osteotomy allowing compression at the fracture site message has been sent. To load your collection due to an error studies, a wide variation exists the! Alignment issues the bone at bottom of the hinge position in medial closed wedge distal femoral osteotomy... To the younger age of this patient population, but it is completed through an anteromedial longitudinal incision, 10!
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