Abstract
Varus deformity with:
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Symptomatic medial unicompartmental osteoarthritis of the knee
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Cartilage regenerative procedures or meniscus replacement
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Unicompartmental medial hypercompression (overload)
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Ligament reconstruction on the convex side of the deformity
Intact cartilage of the lateral compartment (maximal damage level 2 ICRS) and a preserved lateral meniscus are prerequisites.
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Medial open-wedge technique: shifts the mechanical axis laterally through opening an ascending (directed from medial to lateral) osteotomy at the proximal tibial metaphysis.
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Lateral closed-wedge technique: shifts the mechanical axis laterally by closing a wedge-shaped metaphyseal osteotomy on the lateral side of the proximal tibia
Symptom specific history: pain (related to activity, at rest, at night etc.), site of pain, pain free walking distance.
Symptom specific examination: inspection of the weight-bearing axial alignment, gait pattern (thrust), tenderness at the medial or lateral joint line, tenderness on patellar compression/palpation of the undersurface, passive and active flexion/extension, ligamentous stability.
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References
References for Chapter 19.1
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References for Chapter 19.2
Backstein D, Morag G, Hanna S, Safir O, Gross A (2007) Long‐term follow‐up of distal femoral varus osteotomy of the knee. J Arthroplasty 22(Suppl 1):2–6
Finkelstein JA, Gross AE, Davis A (1996) Varus osteotomy of the distal part of the femur. A survivorship analysis. J Bone Joint Surg Am 78:1348–1352
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Wang JW, Hsu CC (2005) Distal femoral varus osteotomy for osteoarthritis of the knee. J Bone Joint Surg Am 87:127–133
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Feucht, M.J., Hinterwimmer, S. (2015). Osteotomy. In: Imhoff, A., Feucht, M. (eds) Surgical Atlas of Sports Orthopaedics and Sports Traumatology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-43776-6_19
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DOI: https://doi.org/10.1007/978-3-662-43776-6_19
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