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The effect of lateral opening wedge distal femoral osteotomy on leg length

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Varisation distal femoral osteotomy is a well-described treatment for lateral compartment arthrosis in the young, active patient. This treatment may potentially alter the length of the lower limb . The objective of this study was to quantify the change in leg length following lateral opening wedge distal femoral osteotomy using a blade plate.

Methods

Between 1998 and 2011, 29 lateral opening wedge distal femoral osteotomies were performed for symptomatic genu valgum with signs of lateral compartment arthrosis or patello-femoral symptoms. The mean age was 44.4 years (±11.3). Average follow-up was 80.2 months (±50.6).

Results

The mean osteotomy opening was 8.3° (±2.3). The femoro-tibial mechanical axis (mFTA) was improved significantly, from 187.8° (±3.5) to 180.4° (±2.6) post-operatively (p < 0.001). The pre-operative leg length discrepancy was −0.7 cm, compared to −0.6 cm post-operatively, which was not significant (n.s.). There were five revisions to arthroplasty for disease progression at meantime of 166.6 months post-operatively. The probability of survival at 60 months was 91.4 % (95 % CI 74.9–100 %) with end-point of revision to total knee arthroplasty and 87.6 % (95 % CI 74.1–100 %) of revision for complications.

Conclusions

Lateral opening wedge distal femoral osteotomy, performed for symptomatic genu valgum, has no effect on leg length. This technique allows good correction of the axis of the lower limb; however, the complication rate is not insignificant (14 %). Complications occurred mainly in post-traumatic cases and may be avoidable with attention to technique and optimum rehabilitation. The procedure should be reserved for young, active patients with significant symptoms.

Level of evidence

IV.

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Acknowledgments

We thank all members of the Laboratoire Biostatistique Santé (UMR 5558, Lyon, France) for their collaboration in the statistical analysis of our work. This work has not received any funds or grants.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Service de chirurgie orthopédique, centre Albert Trillat, Université Claude Bernard, Lyon 1, Hôpital de la Croix-rousse, Hospices civils de Lyon, 103 grande rue de la Croix-rousse, 69004, Lyon, France

    A. Madelaine, T. Lording, V. Villa, S. Lustig, E. Servien & P. Neyret

  2. Frankston Hospital, Hastings Rd, Frankston, VIC, 3199, Australia

    T. Lording

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  1. A. Madelaine
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  2. T. Lording
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  3. V. Villa
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  4. S. Lustig
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  5. E. Servien
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  6. P. Neyret
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Correspondence to A. Madelaine.

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Madelaine, A., Lording, T., Villa, V. et al. The effect of lateral opening wedge distal femoral osteotomy on leg length. Knee Surg Sports Traumatol Arthrosc 24, 847–854 (2016). https://doi.org/10.1007/s00167-014-3387-5

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  • DOI: https://doi.org/10.1007/s00167-014-3387-5

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