Background: No patients noted a leg-length inequality and no persistent symptoms from the iliac crest bone graft site were noted. Medial closing-wedge osteotomy A medial-side distal femoral approach is normally used with a skin incision starting 2 cm distal to the medial epicondyle and extending 15 cm proximally. Additionally, compared to knee replacement patients are allowed to participate in much more rigorous activities. The .gov means its official. 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. Epub 2021 Oct 27. A comment to this article is available at http://dx.doi.org/10.1007/s11999-015-4159-3. Unable to load your collection due to an error, Unable to load your delegates due to an error. 4010 W. 65th St. The https:// ensures that you are connecting to the 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. Although similar . 2022 May;18(2):297-306. doi: 10.1177/15563316211051295. Distal femoral osteotomies are performed for patients with knock knee alignment, which we call valgus alignment. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use. An improved method of preoperative templating and refinement of the intraoperative technique may improve this. 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. Survivorship at 74 months with the endpoint of TKA was 83%. Please enable it to take advantage of the complete set of features! Medial opening-wedge proximal tibial osteotomy for varus knee deformity is commonly performed but lateral opening-wedge distal femoral osteotomy for a valgus knee deformity is less common. 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. Dewilde TR, Dauw J, Vandenneucker H, Bellemans J. Mathews J, Cobb AG, Richardson S, Bentley G. Distal femoral osteotomy for lateral compartment osteoarthritis of the knee. The use of an opening-wedge osteotomy on the tibial side for varus deformity has become well established as the favored alternative to the previously more common closing-wedge techniques [8]. Conclusion: Distal femoral osteotomy is an acceptable surgical option for the young patient with severe unicompartmental knee osteoarthritis and malalignment. Osteotomies around the knee are well-recognized treatments for unloading the affected compartment in cases of lower limb malalignment. 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. 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. Knee Society knee scores improved from 43 to 78. 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). Distal femoral osteotomy (DFO) unloads the lateral joint compartment and can be performed using closing wedge (CW) or opening wedge (OW) techniques. Between 2000 and 2010, we performed 40 distal femoral osteotomies. 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. 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. 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. The authors concluded that osteotomy was indicated in younger (mean, 46 years) high-activity patients, but after 20 years most patients were converted to TKA. 2019 Jul;38(3):351-359. doi: 10.1016/j.csm.2019.02.004. 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. Closed intramedullary osteotomies of the femur. Dr. Garcia will take limb alignment films to identify have much correction is needed. 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%]). [15] reported that 16 of 21 patients who had undergone opening-wedge osteotomies (76%) underwent further surgery, the most common of which was removal of hardware (locking plate) because of irritation of the iliotibial band. Wang and Hsu [20] reported on 30 knees undergoing varus osteotomy with a medial blade plate. In general, most U.S. surgeons perform an opening wedge distal femoral osteotomy to realign the knee. 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. - Contraindications: inflammatory arthritides & restricted knee motion; Distal femoral varus osteotomy for valgus deformity of the knee. Finkelstein JA, Gross AE, Davis A. Varus osteotomy of the distal part of the femur. 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. Two studies [3, 4] on the lateral opening-wedge technique report a mean improvement in the tibiofemoral angle of 11 and 6, respectively. Dewilde et al. Saithna et al. Call Us Today (888) 260-0449 Medial closing-wedge osteotomy has demonstrated good success in treatment of osteoarthritis in published series, but few studies have evaluated distal femoral lateral opening-wedge osteotomy in terms of correction of deformity, pain and function, and survivorship. (3) What are the nonunion, complication, and reoperation rates after lateral opening-wedge osteotomy? The final patient type is very young patients who need cartilage, ligament or meniscus transplant procedures with alignment issues. Its combination with various cartilage repair procedures has been shown to further improve outcomes. Epub 2016 Dec 21. Two knees (two patients) underwent a medial closing-wedge osteotomy and were not included in the present study. Concurrent with this, a plate and screws are placed on the outside of the knee and bone graft is placed into the opening wedge which is created to assist with healing of the gap. 2022 Dec 19;23(1):1105. doi: 10.1186/s12891-022-06078-y. Healy WL, Anglen JO, Wasilewski SA, Krackow KA. 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. OSferions micro- and macroporous structure allows it to be resorbed and replaced by bone during the healing process. Epub 2019 Mar 26. Robert LaPrade, MD, PhD Would you like email updates of new search results? The two groups of patients (arthritis group and joint preservation group) were considered separately when analyzing the data. Bethesda, MD 20894, Web Policies 3, 4) and was ultimately converted to a TKA. PMC 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. An official website of the United States government. 4. *StimuBlast is a registered trademark of AlloSource. 8. See this image and copyright information in PMC. Relative disadvantages include potential for delayed union or nonunion and irritation of the sensitive lateral knee structures by hardware or surgical trauma. Stahelin T, Hardegger F, Ward JC. The patients who underwent a TKA were female (age, 26 and 40.1 years; BMI, 30.5 and 30.7, respectively) and received these procedures 2.4 and 3.2 years after their DFVO because . This realignment moves the force on the arthritis part of the knee to the normal part. 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. 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. In situations where the lateral cortex or anteromedial cortex has been inadvertently fractured, the Two-Hole Osteotomy Support Plate Implant System can be utilized to help fixate these fractures. Distal femoral varus osteotomy for osteoarthritis of the knee. Return to Sport and Work Following Distal Femoral Varus Osteotomy: A Systematic Review. We only report on 21 of 31 knees in regard to alignment correction, because full-length radiographs were not available on all patients. Feucht MJ, Winkler PW, Mehl J, Bode G, Forkel P, Imhoff AB, Lutz PM. 1 Even with evolving fixation strategies and implants, . may email you for journal alerts and information, but is committed This work was performed at Scripps Clinic, La Jolla, CA, USA. Distal femoral osteotomy can be technically demanding and various complications are reported in the literature. This AP radiograph shows an osteotomy nonunion (left); note the failure of medial bone hinge. 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). 2021 Jul;34(8):816-821. doi: 10.1055/s-0039-3400742. 2700 Vikings Circle Results: 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. Jacobi M, Wahl P, Bouaicha S, Jakob RP, Gautier E. Distal femoral varus osteotomy: problems associated with the lateral open-wedge technique. Most osteotomies done are opening wedge as previously described. official website and that any information you provide is encrypted 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. 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. Eberbach H, Mehl J, Feucht MJ, Bode G, Sdkamp NP, Niemeyer P. Am J Sports Med. 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%]). In general, this is a successful procedure if done for the right indications. Correction of valgus knee deformity with a supracondylar V osteotomy. Your message has been successfully sent to your colleague. 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. Osteotomies around the knee are well-recognized treatments for unloading the affected compartment in cases of lower limb malalignment. Conclusions: Time to radiographic union, complications, and reoperations were captured. Previous attempts to make it better provided only temporary relief. A survivorship analysis. Eagan, MN 55121, I struggled with my knee for 18 months - having gone from 10,000 steps a day to only walking as needed. For cartilage patients the cut off is slightly lower at 3-4 degrees of valgus. These are the lateral opening wedge osteotomy, whereby a bone wedge is placed into the outside portion of the femur to change the alignment or a closing wedge medial distal femoral osteotomy, whereby a bone wedge is taken out and the bone is collapsed down to change the alignment. In general, it is felt that younger patients definitively should have a distal femoral osteotomy when it is indicated, whereas older patients may equally benefit from a distal femoral osteotomy or a total knee replacement, depending upon their overall activity levels, if they have other medical problems, and if their bone is relatively osteopenic (softer than normal). 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). The ContourLock distal femoral osteotomy plates are designed to work in conjunction with the Osteotomy Instrument System. 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. 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. 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. The fascia over the vastus medialis is incised and retracted laterally and anteriorly to expose the femoral shaft. 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. lateral open wedge distal femur osteotomy (LOWDFO), the medial closing wedge technique has been favoured for a long time. In this article, we will summarize the indications for DFO, the surgical techniques reported in the literature, and their outcomes. official website and that any information you provide is encrypted 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.
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Background: No patients noted a leg-length inequality and no persistent symptoms from the iliac crest bone graft site were noted. Medial closing-wedge osteotomy A medial-side distal femoral approach is normally used with a skin incision starting 2 cm distal to the medial epicondyle and extending 15 cm proximally. Additionally, compared to knee replacement patients are allowed to participate in much more rigorous activities. The .gov means its official. 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. Epub 2021 Oct 27. A comment to this article is available at http://dx.doi.org/10.1007/s11999-015-4159-3. Unable to load your collection due to an error, Unable to load your delegates due to an error. 4010 W. 65th St. The https:// ensures that you are connecting to the 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. Although similar . 2022 May;18(2):297-306. doi: 10.1177/15563316211051295. Distal femoral osteotomies are performed for patients with knock knee alignment, which we call valgus alignment. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use. An improved method of preoperative templating and refinement of the intraoperative technique may improve this. 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. Survivorship at 74 months with the endpoint of TKA was 83%. Please enable it to take advantage of the complete set of features! Medial opening-wedge proximal tibial osteotomy for varus knee deformity is commonly performed but lateral opening-wedge distal femoral osteotomy for a valgus knee deformity is less common. 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. Dewilde TR, Dauw J, Vandenneucker H, Bellemans J. Mathews J, Cobb AG, Richardson S, Bentley G. Distal femoral osteotomy for lateral compartment osteoarthritis of the knee. The use of an opening-wedge osteotomy on the tibial side for varus deformity has become well established as the favored alternative to the previously more common closing-wedge techniques [8]. Conclusion: Distal femoral osteotomy is an acceptable surgical option for the young patient with severe unicompartmental knee osteoarthritis and malalignment. Osteotomies around the knee are well-recognized treatments for unloading the affected compartment in cases of lower limb malalignment. 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. 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. Knee Society knee scores improved from 43 to 78. 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). Distal femoral osteotomy (DFO) unloads the lateral joint compartment and can be performed using closing wedge (CW) or opening wedge (OW) techniques. Between 2000 and 2010, we performed 40 distal femoral osteotomies. 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. 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. 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. The authors concluded that osteotomy was indicated in younger (mean, 46 years) high-activity patients, but after 20 years most patients were converted to TKA. 2019 Jul;38(3):351-359. doi: 10.1016/j.csm.2019.02.004. 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. Closed intramedullary osteotomies of the femur. Dr. Garcia will take limb alignment films to identify have much correction is needed. 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%]). [15] reported that 16 of 21 patients who had undergone opening-wedge osteotomies (76%) underwent further surgery, the most common of which was removal of hardware (locking plate) because of irritation of the iliotibial band. Wang and Hsu [20] reported on 30 knees undergoing varus osteotomy with a medial blade plate. In general, most U.S. surgeons perform an opening wedge distal femoral osteotomy to realign the knee. 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. - Contraindications: inflammatory arthritides & restricted knee motion; Distal femoral varus osteotomy for valgus deformity of the knee. Finkelstein JA, Gross AE, Davis A. Varus osteotomy of the distal part of the femur. 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. Two studies [3, 4] on the lateral opening-wedge technique report a mean improvement in the tibiofemoral angle of 11 and 6, respectively. Dewilde et al. Saithna et al. Call Us Today (888) 260-0449 Medial closing-wedge osteotomy has demonstrated good success in treatment of osteoarthritis in published series, but few studies have evaluated distal femoral lateral opening-wedge osteotomy in terms of correction of deformity, pain and function, and survivorship. (3) What are the nonunion, complication, and reoperation rates after lateral opening-wedge osteotomy? The final patient type is very young patients who need cartilage, ligament or meniscus transplant procedures with alignment issues. Its combination with various cartilage repair procedures has been shown to further improve outcomes. Epub 2016 Dec 21. Two knees (two patients) underwent a medial closing-wedge osteotomy and were not included in the present study. Concurrent with this, a plate and screws are placed on the outside of the knee and bone graft is placed into the opening wedge which is created to assist with healing of the gap. 2022 Dec 19;23(1):1105. doi: 10.1186/s12891-022-06078-y. Healy WL, Anglen JO, Wasilewski SA, Krackow KA. 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. OSferions micro- and macroporous structure allows it to be resorbed and replaced by bone during the healing process. Epub 2019 Mar 26. Robert LaPrade, MD, PhD Would you like email updates of new search results? The two groups of patients (arthritis group and joint preservation group) were considered separately when analyzing the data. Bethesda, MD 20894, Web Policies 3, 4) and was ultimately converted to a TKA. PMC 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. An official website of the United States government. 4. *StimuBlast is a registered trademark of AlloSource. 8. See this image and copyright information in PMC. Relative disadvantages include potential for delayed union or nonunion and irritation of the sensitive lateral knee structures by hardware or surgical trauma. Stahelin T, Hardegger F, Ward JC. The patients who underwent a TKA were female (age, 26 and 40.1 years; BMI, 30.5 and 30.7, respectively) and received these procedures 2.4 and 3.2 years after their DFVO because . This realignment moves the force on the arthritis part of the knee to the normal part. 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. 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. In situations where the lateral cortex or anteromedial cortex has been inadvertently fractured, the Two-Hole Osteotomy Support Plate Implant System can be utilized to help fixate these fractures. Distal femoral varus osteotomy for osteoarthritis of the knee. Return to Sport and Work Following Distal Femoral Varus Osteotomy: A Systematic Review. We only report on 21 of 31 knees in regard to alignment correction, because full-length radiographs were not available on all patients. Feucht MJ, Winkler PW, Mehl J, Bode G, Forkel P, Imhoff AB, Lutz PM. 1 Even with evolving fixation strategies and implants, . may email you for journal alerts and information, but is committed
This work was performed at Scripps Clinic, La Jolla, CA, USA. Distal femoral osteotomy can be technically demanding and various complications are reported in the literature. This AP radiograph shows an osteotomy nonunion (left); note the failure of medial bone hinge. 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). 2021 Jul;34(8):816-821. doi: 10.1055/s-0039-3400742. 2700 Vikings Circle Results: 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. Jacobi M, Wahl P, Bouaicha S, Jakob RP, Gautier E. Distal femoral varus osteotomy: problems associated with the lateral open-wedge technique. Most osteotomies done are opening wedge as previously described. official website and that any information you provide is encrypted 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. 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. Eberbach H, Mehl J, Feucht MJ, Bode G, Sdkamp NP, Niemeyer P. Am J Sports Med. 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%]). In general, this is a successful procedure if done for the right indications. Correction of valgus knee deformity with a supracondylar V osteotomy. Your message has been successfully sent to your colleague. 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. Osteotomies around the knee are well-recognized treatments for unloading the affected compartment in cases of lower limb malalignment. Conclusions: Time to radiographic union, complications, and reoperations were captured. Previous attempts to make it better provided only temporary relief. A survivorship analysis. Eagan, MN 55121, I struggled with my knee for 18 months - having gone from 10,000 steps a day to only walking as needed. For cartilage patients the cut off is slightly lower at 3-4 degrees of valgus. These are the lateral opening wedge osteotomy, whereby a bone wedge is placed into the outside portion of the femur to change the alignment or a closing wedge medial distal femoral osteotomy, whereby a bone wedge is taken out and the bone is collapsed down to change the alignment. In general, it is felt that younger patients definitively should have a distal femoral osteotomy when it is indicated, whereas older patients may equally benefit from a distal femoral osteotomy or a total knee replacement, depending upon their overall activity levels, if they have other medical problems, and if their bone is relatively osteopenic (softer than normal). 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). The ContourLock distal femoral osteotomy plates are designed to work in conjunction with the Osteotomy Instrument System. 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. 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. 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. The fascia over the vastus medialis is incised and retracted laterally and anteriorly to expose the femoral shaft. 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. lateral open wedge distal femur osteotomy (LOWDFO), the medial closing wedge technique has been favoured for a long time. In this article, we will summarize the indications for DFO, the surgical techniques reported in the literature, and their outcomes. official website and that any information you provide is encrypted 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.
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Can An Executor Be Reimbursed For Meals,
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Van Mendelson Vs. Attorney General Guyana On Friday the 16th December 2022 the Chief Justice Madame Justice Roxanne George handed down an historic judgment...