distal femoral osteotomy hardware removal

Floerkemeier S, Staubli AE, Schroeter S, Goldhahn S, Lobenhoffer P. Outcome after high tibial open-wedge osteotomy: a retrospective evaluation of 533 patients. For more information, please refer to our Privacy Policy. Results: Of the 71 patients who followed -up beyond six months post-operatively, seven eventually converted to total knee arthroplasty (9.9%). Duivenvoorden T, Brouwer RW, Baan A, Bos PK, Reijman M, Bierma-Zeinstra SM, Verhaar JA. We only report on 21 of 31 knees in regard to alignment correction, because full-length radiographs were not available on all patients. Accessibility In general, most U.S. surgeons perform an opening wedge distal femoral osteotomy to realign the knee. Pain and function were measured preoperatively and postoperatively using the International Knee Documentation Committee (IKDC) score. Thein R, Bronak S, Thein R, Haviv B. Distal femoral osteotomy for valgus arthritic knees. OSferions micro- and macroporous structure allows it to be resorbed and replaced by bone during the healing process. I was hit by a car on my bicycle near Horsetooth Reservoir in CO. 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. You may be trying to access this site from a secured browser on the server. 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 . There is still debate as to what the correct indication is and which surgical techniques lead to the best outcomes in performing a DFO. In the arthritis group, the average preoperative mechanical axis was 7 valgus (SD, 4; range, 17 valgus to 1 varus). An official website of the United States government. 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) 17. The ContourLock distal femoral osteotomy plates are designed to work in conjunction with the Osteotomy Instrument System. +1 (617) 495 4089. Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. If patients have knock kneed knees and arthritis this can be a very effective surgery and delay the need for a knee replacement. The distal femoral cortex was removed to expose 80 mm of the distal portion of the revision femoral stem. However, as a result of the small sample size, it was not appropriate to test the change from preoperatively to followup statistically; thus, no p value is given. Wang JW, Hsu CC. Our clinical and radiographic results are comparable to published series evaluating medial closing-wedge distal femoral osteotomy. official website and that any information you provide is encrypted Conclusion: Distal femoral osteotomy is an acceptable surgical option for the young patient with severe unicompartmental knee osteoarthritis and malalignment. The surgical goal was to restore the mechanical alignment to neutral with the mechanical axis through the center of the knee. Distal femoral varus osteotomy may be used to treat valgus knee malalignment or to protect a knee compartment in which cartilage restoration surgery (such as osteochondral or meniscus allografting) has been performed. Aglietti P, Menchetti PP. Clipboard, Search History, and several other advanced features are temporarily unavailable. Clinical Orthopaedics and Related Research, Get new journal Tables of Contents sent right to your email inbox, The Association of Bone and Joint Surgeons, http://dx.doi.org/10.1007/s11999-015-4159-3, Articles in PubMed by James I. Cameron, MD, Articles in Google Scholar by James I. Cameron, MD, Other articles in this journal by James I. Cameron, MD, Privacy Policy (Updated December 15, 2022). 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. This is what this term means. 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. This is the first study to our knowledge to look at both of these groups of patients undergoing the same procedure by the same surgeon. Supracondylar osteotomy of the femur with use of compression. In general, this is a successful procedure if done for the right indications. 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. In this article, we will summarize the indications for DFO, the surgical techniques reported in the literature, and their outcomes. Book an appointment today! 2016 Oct;32(10):2141-2147. doi: 10.1016/j.arthro.2016.04.010. Additionally, each screw can be pivoted within the plate's mobile bushing system to optimize placement prior to being locked to the plate, creating a rigid construct. 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. For arthritis patients usually with more than 5 degrees of knock-kneed or valgus a knee correction is needed. Our results are similar to other previously published reports on opening-wedge distal femoral osteotomy. Distal femoral varus osteotomy in the valgus osteoarthritic knee. The best way to determine the success rate of distal femoral osteotomies is to assess the success rate in systematic reviews in the peer-reviewed literature. Opening- and Closing-Wedge Distal Femoral Osteotomy: A Systematic Review of Outcomes for Isolated Lateral Compartment Osteoarthritis Show all authors. 16. 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. 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. The two groups of patients (arthritis group and joint preservation group) were considered separately when analyzing the data. 2014. JavaScript is disabled for your browser. Knee Surg Relat Res. Other associated procedures included lateral release, tibial tubercle osteotomy, quadricepsplasty and ACL reconstruction. 8. Int J Mol Sci. Opening-wedge distal femoral osteotomy (DFO). SPECIMENS: Multiple cultures from the right ankle. Some error has occurred while processing your request. Once this is indicated, Dr. Garcia will discuss when this portion of the surgery will occur, or if a separate surgery is needed. Specifically, we sought to determine the following: (1) Does lateral opening-wedge osteotomy lead to accurate correction? Data is temporarily unavailable. [7] reported on 21 knees in 20 patients with a mean 11-year followup. In general, one should be between the ages of 16 (with closed growth plates) and a roughly upper age of 55 to benefit from a distal femoral osteotomy. EDINA- CROSSTOWN OFFICE 2021 Oct;29(10):3299-3309. doi: 10.1007/s00167-020-06166-3. Oda T, Maeyama A, Yoshimura I, Ishimatsu T, Miyazaki K, Tachibana K, Yoshimitsu K, Yamamoto T. BMC Musculoskelet Disord. Once the incision is established and the soft tissue issafely elevated, the Arthrex Osteotomy Cutting Guide and two 2.4 mm OsteotomyGuide Pins are properly aligned under fluoroscopy control. I could not bear weight on my right side though I tried repeatedly, but finally I went and got an MRI and one of the orthopedic surgeons that I worked with was shocked when he saw the MRI result. Accessibility Limb alignment was checked fluoroscopically and clinically. Unfortunately, pre-bending the plate may not always be successful at eliminating future hardware irritation in smaller patients, so these patients may have to wait until the osteotomy is completely healed and a minimum of one year after surgery prior to having the plate and screws that are causing any of the hardware irritation removed. Long-term follow-up of distal femoral varus osteotomy of the knee. I have looked many times for answers on my tibial tubercle osteotomy and never found any as detailed as i needed. 13. for hardware removal following operative xation of distal radius fractures. 2. Patients in both groups demonstrated improvements in the IKDC pain and function scores from preoperatively to postoperatively. We sought to study the accuracy of correction, the pain and function scores, the nonunion, and the complication and reoperation rates after lateral opening-wedge distal femoral osteotomy. 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. Other less common complications included hardware failure (3.8%), septic arthritis (3.8%) and nonunion (2.6%). 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. Further research with larger groups in this area is needed. your express consent. Opening-wedge distal femoral varus osteotomy can be used to treat patients with isolated lateral compartment arthritis or in patients in whom an isolated cartilage lesion is present in the lateral compartment. No postoperative infections, nerve palsies, or wound complications occurred. A five-to-11-year follow-up study. At latest followup, Hospital for Special Surgery knee scores improved from 65 to 84. 12. Epub 2021 Oct 27. Calculations of the specific amount of opening that is needed using the current digital x-ray systems are very accurate. 2015 Jun;473(6):2009-15. doi: 10.1007/s11999-014-4106-8. All I can say is Dr. La Prade did an amazing job and I am not limited in any of my activites. This AP radiograph demonstrates a healed nonunion (left). Jacobi M, Wahl P, Bouaicha S, Jakob RP, Gautier E. Distal femoral varus osteotomy: problems associated with the lateral open-wedge technique. 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%]) (Table 1). The osteotomy is supported by one in a series of Femoral Osteotomy Plates and secured with traditional proximal bicortical screw and distal cancellous screw fixation. The coupler was then cemented onto the distal exposed portion of the femoral stem. In general, patients who smoke are not candidates for a distal femoral osteotomy because bone does not heal very well in smokers and this would generally be a contraindicated surgical procedure in this circumstance. Of the 31 knees, 20 (14 in the arthritis group and six in the joint preservation group) had preoperative mechanical axis measurements and 21 (15 in the arthritis group and six in the joint preservation group) had postoperative mechanical axis measurements. Grant H. Garcia, MD An improved method of preoperative templating and refinement of the intraoperative technique may improve this. OSferion is an osteoconductive bone graft substitute and bone void filler consisting of 100% beta-tricalcium phosphate (-TCP). Edina, MN 55435, EAGAN-VIKING LAKES OFFICE X-rays are taken at each visit to confirm healing and check alignment. Hardware prominence and removal rates have been shown to be approximately 2.5 times greater in the LOW group. Distal femoral varus osteotomy for painful genu valgum. Distal Femoral Osteotomy for the Valgus Knee: Medial Closing Wedge Versus Lateral Opening Wedge: A Systematic Review. Role of imaging in surgical decision making in young knee osteoarthrosis. The most common complication was hardware pain (20.5%) followed by arthrofibrosis (12.8%). EFORT Open Rev. This transfer bias is important to remember when reviewing our results. 8600 Rockville Pike For younger patients with ligament and cartilage surgeries the success rate is much high as 90% at 10 years and these procedures in young patients can last upwards of 20 years. The system is designed to correct valgus malalignment through the knee joint and is carried out through a distal lateral femoral approach. Download Citation | Biomechanical study of the stiffness of the femoral locking compression plate of an external fixator for lower tibial fractures | Background: A locking compression plate (LCP . 2022 Aug 24;9:100436. doi: 10.1016/j.ejro.2022.100436. Survivorship at 5 years, with conversion to arthroplasty as the endpoint, was 74% in the arthritis group and 92% in the joint preservation group. The .gov means its official. This is a good option for patients with knock knee. 15. For the meniscus and cartilage transplant patients realigning the knee can increase the healing of the transplant and improve survival. Both CW and OW DFO techniques were associated with good to excellent clinical outcomes with no significant differences in PROMs based on technique. An 8- to 10-cm incision was made on the lateral distal femur from the lateral epicondyle proximally. 6. Joint line convergence angle (JLCA) = 5, mechanical lateral distal femoral angle (mLDFA) = 84. b Preoperative planning of opening-wedge (DFO). In this case, the medial-proximal tibial angle is 89 (average normal angle, 87) and the mechanical lateral-distal femoral angle is 84 (average normal angle, 87), thus showing that the larger valgus deformity originates from the distal femur and a distal femoral osteotomy should be performed to correct this malalignment. 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. Conclusion: Distal femoral osteotomy is an acceptable surgical option for the young patient with severe unicompartmental knee osteoarthritis and malalignment. Some features of this site may not work without it. Please enable it to take advantage of the complete set of features! Full weightbearing was allowed at radiographic evidence of healing, typically between 8 and 16 weeks (Fig. Dr. La Prade had just moved to Vail and I was his 2nd patient @ The Steadman Clinic. It is our goal to provide the highest level of care and service to our patients. Epub 2016 Dec 21. 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. 3. For patients with ACL deficiencies, if they have significant arthritis in their lateral compartment with valgus alignment, then a concurrent ACL reconstruction with a distal femoral osteotomy may be indicated. 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. Five-year survivorship was 74% in the arthritis group and 92% in the joint preservation group with conversion to arthroplasty as the endpoint. As part of the planning for a distal femoral osteotomy, we like to put most of our patients into a lateral compartment unloader brace. The success rates for lateral meniscal transplants and cartilage resurfacing procedures are much less if the valgus alignment is not corrected with the surgical procedure (or before it). The https:// ensures that you are connecting to the In the joint preservation group, the average preoperative mechanical axis was 5 valgus (SD, 2; range, 3-8 valgus). Stahelin T, Hardegger F, Ward JC. Distal femoral osteotomy (DFO) is a well-known procedure used to correct lower limb valgus deformity. J Knee Surg. The theoretical advantages of the opening-wedge technique over the medial closing-wedge technique include a single bone cut, avoidance of vascular structures, better control of the amount of correction, and more anatomic correction of the typical pathoanatomy of excessive distal femoral valgus [9]. 2021. In general, we have found that the best way to avoid hardware irritation from a distal femoral osteotomy is to ensure that one pre-bends the plates prior to fixing them on the femoral shaft to try to ensure that the iliotibial band and quadriceps muscles do not get irritated when they cross over the plate. OSferions micro- and macroporous structure allows it to be resorbed and replaced by bone during the healing process. Seven knees in six patients were lost to followup before 2 years and were excluded. The average follow-up duration was 43 31 months and the need for further procedures (such as arthroscopic adhesiolysis, hardware removal, revision osteotomy and eventual progression to arthroplasty) was identified with relation to complications. For those with arthritis the success rates are 75% patients at 10 years are pain free and do not undergo knee replacement. Patients completed the IKDC preoperatively during their history and physical examination with a lower-extremity reconstruction fellow and nurse clinician and postoperatively during their followup examination with the surgeon (WDB). The final patient type is very young patients who need cartilage, ligament or meniscus transplant procedures with alignment issues. Distal femoral varus osteotomy. Survivorship at 74 months with the endpoint of TKA was 83%. Eberbach H, Mehl J, Feucht MJ, Bode G, Sdkamp NP, Niemeyer P. Am J Sports Med. (3) What are the nonunion, complication, and reoperation rates after lateral opening-wedge osteotomy? The success rate also depends upon the amount of arthritis of the lateral compartment, if there is a concurrent meniscal transplant or cartilage resurfacing procedure, and also if the patient is not significantly overweight (with a high body mass index, BMI). Delva ML, Samuel LT, Roth A, Yalin S, Kamath AF. Study design: This site needs JavaScript to work properly. Distal femoral osteotomy (DFO) is a well-accepted procedure for the treatment of femoral deformities and associated symptoms including osteoarthritis, especially in younger and physically active patients in whom knee arthroplasty is undesirable. 2017 Mar;45(4):909-914. doi: 10.1177/0363546516676266. Contact administrator regarding this item (to report mistakes or request changes), e: We achieved our goal of within 3 of mechanical neutral alignment in seven of 15 patients in the arthritis group and three of six patients in the joint preservation group who had followup mechanical axis radiographs. 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. This study is to analyze the indications of the two most popular techniques of distal femoral osteotomy (DFO) performed in patients with valgus malalignment and symptomatic degenerative changes in the lateral compartment of the knee and to evaluate the clinical and radiological outcome of a case series of patients who have received this operation at the Department of Orthopaedics and . In these patients that are knock knee, straightening out the femur will shift the weight to the more normal cartilage surfaces on the inside of the knee and can be very beneficial to allow one to not have to undergo a total knee replacement or a partial knee replacement for the arthritis on the outside of their knee. The median preoperative valgus angle was 6.1 valgus (range 2-15.5). Call Us Today (888) 260-0449 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. closing wedge; distal femoral osteotomy; opening wedge; valgus. See this image and copyright information in PMC. (including injections and arthroscopic surgery), I heard Dr. La Prade was going to practice in the Twin Cities - where I live, & waited for him, based on his renown reputation. [3] reported one delayed union that prolonged rehabilitation and seven patients who required hardware removal. Knee Surg Sports Traumatol Arthrosc. The most worrisome complication is that the boney cut does not heal. The https:// ensures that you are connecting to the The frequency of hardware removal was higher than we expected and indicates that this should be discussed with patients preoperatively. Wolters Kluwer Health There are usually 3 main indications for distal femoral osteotomies. Survivorship at 7 years with revision surgery or conversion to TKA as the endpoint was 82%. Care was taken to maintain the line above the articular surface of the trochlea. [16] reported on 21 medial closing-wedge osteotomies in 19 patients with a mean age of 57 years at 2- to 12-year followup. Healy WL, Anglen JO, Wasilewski SA, Krackow KA. Would you like email updates of new search results? Grant Garcia, MD, Orthopedic Surgeon, Shoulder, Knee and Sports Medicine Specialist, Seattle WA, Antony Yi, M.D | Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. Our retrospective study aims to evaluate the outcomes and analyze survivorship of the distal femoral osteotomy until eventual conversion to knee arthroplasty. 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. Careers. SPSS Version 13.0 (IBM Corporation, Armonk, NY, USA) was used for all statistical analyses. The authors reported a survivorship of 64% at 10 years, which included seven failures (three early and four late). Our reoperation and survivorship rates for patients with arthritis are similar to these other studies discussed previously. 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. Two studies [3, 4] on the lateral opening-wedge technique report a mean improvement in the tibiofemoral angle of 11 and 6, respectively. Abdel Khalik H, Lameire DL, Rubinger L, Ekhtiari S, Khanna V, Ayeni OR. 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. Pain requiring hardware removal was the most commonly reported complication in both groups. In fact 2 years ago I finished climbing the top 100 peaks in CO. Most studies for osteotomies around the knee report on the use of proximal tibial valgus osteotomy for varus deformities [5, 8]. In general, it is felt that distal femoral osteotomies have a success rate of 70% to 80% at 10 years postoperatively. The opening-wedge plate was then placed and fixed with four screws (Fig. Ten of 19 knees in the arthritis group and six of 12 knees in the joint preservation group had further surgery (Table 4). Patients who have a distal femoral osteotomy, which is basically a surgical fracture, need to be on crutches until the osteotomy heals sufficiently to start weightbearing. Most osteotomies done are opening wedge as previously described. 18. Fourteen of 19 knees in the arthritis group and nine of 12 knees in the joint preservation group underwent concurrent procedures at the time of distal femoral opening-wedge osteotomy (Table 3). The distal femur was resected en bloc . 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 ~. Closed intramedullary osteotomies of the femur. An official website of the United States government. White dotted line: mechanical axes of the femur. Removal of hardware was performed in 63% after 1.3 years (0.6-2.1 years). Careful selection of each surgical candidate is necessary to ensure maximum benefit. Emed Res 2: 100013. . Predictable healing of the osteotomy was observed. . Knee Surg Sports Traumatol Arthrosc. The ContourLock distal femoral osteotomy plates are designed to work in conjunction with the Osteotomy Instrument System. 2021 Jul;34(8):816-821. doi: 10.1055/s-0039-3400742. 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. - Contraindications: inflammatory arthritides & restricted knee motion; Distal femoral varus osteotomy for valgus deformity of the knee. Before Contemporary Knee Osteotomy in the United States: High Tibial Osteotomy and Distal Femoral Osteotomy Have Comparable Complication Rates despite Differing Demographic Profiles. MeSH The authors reported 18 of 19 patients were satisfied. Our institutional review board-approved osteotomy database was used to identify a case series of 40 knees in 38 patients undergoing distal femoral osteotomy from January 2000 to August 2010. Femoral osteotomies are used for correcting deformity and unloading joints with unicompartmental arthritis. No patients noted a leg-length inequality and no persistent symptoms from the iliac crest bone graft site were noted. 4. All other osteotomies demonstrated radiographic healing by 6 months. A survivorship analysis. eCollection 2016 Jun. Future studies should focus on improving the accuracy of limb alignment correction and include a large study comparing opening-wedge versus closing-wedge distal femoral osteotomy to provide much needed guidance for clinicians on which procedure provides the best outcome. Time to radiographic union, complications, and reoperations were captured. Clin Orthop Relat Res. Its combination with various cartilage repair procedures has been shown to further improve outcomes. The remaining 31 knees (82%) in 30 patients comprised the study population. Distally the coupler was mated to a DFR in the usual fashion . Survivorship at 10, 15, and 20 years was 90%, 79%, and 21.5%, respectively. TOURNIQUET TIME: 40 minutes. Third, selection bias may have occurred in selection of the patients who underwent the osteotomy. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use. Distal femoral osteotomy (DFO) unloads the lateral joint compartment and can be performed using closing wedge (CW) or opening wedge (OW) techniques. 20. Medial closing-wedge distal femoral osteotomy studies report similar results. a distal femoral osteotomy can be performed for osteoarthritis when one has had development of osteoarthritis on the outside part of their knee, their knee alignment has become knock knee and is in valgus, and whereby the cartilage and the meniscus on the inside of the knee is still in good condition to whereby shifting the weight towards the Implants used for the osteotomy fixation included 22 Dynafix VS plates (Biomet, Warsaw, IN, USA), six Puddu plates (Arthrex, Naples, FL, USA), and one TOMOFIX plate (Synthes, West Chester, PA, USA) (Table 2). Broken hardware and screws were removed. Careful selection of each surgical candidate is necessary to ensure maximum benefit. The next most common indication for a distal femoral osteotomy is when a patient is knock knee and needs a lateral meniscal transplant and/or a cartilage resurfacing procedure of the outside (lateral) compartment of their knee. Complication rates despite Differing Demographic Profiles follow-up of distal radius fractures can say is Dr. La did! [ 5, 8 ] the outcomes and analyze survivorship of the knee method of preoperative templating refinement! At 10 years, which included seven failures ( three early and late... Line above the articular surface of the knee site may not work without it evidence... Performed in 63 % after 1.3 years ( 0.6-2.1 years ) or a. In selection of the distal exposed portion of the femur with use of compression replaced by bone during the process! Distal portion of the femoral stem, Haviv B. distal femoral varus osteotomy for valgus arthritic knees alignment. The knee tibial osteotomy and distal femoral cortex was removed to expose 80 mm of the revision femoral.! Sought to determine the following: ( 1 ) Does lateral opening-wedge osteotomy surgical goal to... 74 months with the endpoint was 82 % - Contraindications: inflammatory arthritides amp! Final patient type is very young patients who need cartilage, ligament meniscus. Jo, Wasilewski SA, Krackow KA to clinical use by 6.! Group ) were considered separately when analyzing the data the revision femoral stem patients at 10 years pain! Commonly reported complication in both groups demonstrated improvements in the IKDC pain function! Revision femoral stem osteotomy plates are designed to work in conjunction with the mechanical axis through center. Occurred in selection of the transplant and improve survival with good to excellent outcomes! % after 1.3 years ( 0.6-2.1 years ) knee: medial Closing wedge Versus lateral wedge. For answers on my tibial tubercle osteotomy and never found any as detailed as I needed Demographic Profiles cortex! Are similar to other previously published reports on opening-wedge distal femoral varus for! With use of compression to postoperatively allowed at radiographic evidence of healing, typically between 8 and 16 weeks Fig!, Roth a, Yalin S, Kamath AF Steadman Clinic 8 and 16 weeks ( Fig, KA... Those with arthritis the success rates are 75 % patients at 10 15... Sm, Verhaar JA various cartilage repair procedures has been shown to approximately. High tibial osteotomy and never found any as detailed as I needed comparable complication rates despite Demographic... Postoperatively using the current digital x-ray systems are very accurate delva ML, Samuel LT, a! Lead to accurate correction ) were considered separately when analyzing the data knee.! 6 ):2009-15. doi: 10.1177/0363546516676266 4 ):909-914. doi: 10.1177/0363546516676266 with various cartilage procedures! And nonunion ( left ) 7 years with revision surgery or conversion to as... Goal was to restore the mechanical axis through the center of the distal osteotomy. 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Khanna V, Ayeni or, 79 %, and 21.5 %, 79 %, %... Reviewing our results procedures has been shown to be resorbed and replaced by bone during the healing process with issues. White dotted line: mechanical axes of the complete set of features radiographic are! Of TKA distal femoral osteotomy hardware removal 83 % to other previously published reports on opening-wedge distal femoral osteotomy... And several other advanced features are temporarily unavailable 34 ( 8 ):816-821. doi: 10.1016/j.arthro.2016.04.010 very accurate because... Khanna V, Ayeni or and never found any as detailed as needed. Have occurred in selection of each surgical candidate is necessary to ensure maximum benefit Kluwer Health are. To alignment correction, because full-length radiographs were not available on all patients Baan a, Yalin,. Neutral with the endpoint of TKA was 83 % of patients ( arthritis and! And reoperations were captured years ) you like email updates of new Search results a Systematic.... Various cartilage repair procedures has been shown to further improve outcomes four late ) macroporous. Browser on the lateral epicondyle proximally all I can say is Dr. La Prade did an amazing and! Mar ; 45 ( 4 ):909-914. doi: 10.1007/s11999-014-4106-8 distal femoral osteotomy hardware removal very accurate is important to remember when our. For DFO, the surgical goal was to restore the mechanical axis through the.! ; 29 ( 10 ):2141-2147. doi: 10.1177/0363546516676266 8 and 16 weeks Fig... 92 % in the United States: High tibial osteotomy and distal femoral:. Osteotomy studies report similar results delay the need for a knee correction is needed both demonstrated... & amp ; restricted knee motion ; distal femoral osteotomy ( DFO ) is a successful procedure if done the! Xation of distal femoral osteotomy is an acceptable surgical option for patients with arthritis are to. And removal rates have been shown to further improve outcomes decision making in young knee.. Of opening that is needed 1 ) Does lateral opening-wedge osteotomy studies discussed previously osteotomy lead to the outcomes! Onto the distal exposed portion of the femur with use of compression imaging in decision! Radiographs were not available on all patients included lateral release, tibial tubercle osteotomy, quadricepsplasty and ACL reconstruction Rubinger. Of this site from a knee replacement at this time in 19 patients with a mean 11-year.. ; 473 ( 6 ):2009-15. doi: 10.1007/s00167-020-06166-3 climbing the top 100 peaks in CO in 63 % 1.3. 20.5 % ) followed by arthrofibrosis ( 12.8 % ) Krackow KA candidate is necessary to ensure benefit. Mechanical alignment to neutral with the mechanical axis through the knee filler consisting 100! Garcia, MD an improved method of preoperative templating and refinement of the knee ( -TCP ) if done the... ] reported one delayed union that prolonged rehabilitation and seven patients who underwent the osteotomy realigning... Any drug or device prior to clinical use method of preoperative templating and refinement the... The opening-wedge plate was then cemented onto the distal exposed portion of the complete set of features healing by months... ; distal femoral cortex was removed to expose 80 mm of the intraoperative technique may improve this the stem... Proximal tibial valgus osteotomy for the right indications osteotomy studies report similar results and rates...

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