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Distal femoral osteotomy for valgus arthritic knees

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

Patients with genu valgum and isolated osteoarthritis of the lateral compartment are candidates for distal femoral varus osteotomy. Opening wedge osteotomy is a precise method to realign the knee axis with good short to midterm results. The aim of this study was to evaluate the outcome of patients who have had opening wedge distal femoral varus osteotomy utilizing the Puddu plate (Arthrex, Naples, FL, USA) fixation.

Methods

The study included 6 patients (7 knees) followed for an average of 6.5 ± 1.5 years after distal femoral varus osteotomy with Puddu fixation and iliac crest allograft. Clinical outcome was assessed by the Oxford Knee Score and subjective satisfaction rating. Pre- and postoperative radiographs were evaluated for tibiofemoral angle, Insall-Salvati index and Kellgren-Lawrence Grading Scale for osteoarthritis.

Results

The mean age at surgery was 46.7 ± 10.7 years. The mean body mass index at surgery was 29.6 ± 5.6 kg/m2. Overall at the last follow-up the mean Oxford Knee Score improved from 13.1 ± 8.6 to 26 ± 12.5. The average subjective satisfaction rate at the last follow-up was 6.6 ± 2.8. The measured tibiofemoral angle was corrected by an average of 11.9°. There was no worsening of arthritic changes in comparison to the preoperational radiographs. All radiographs showed full incorporation of the bone grafts, and there were no hardware failures. At the end of this study none of the patients required additional surgery, and none had knee replacement.

Conclusions

Opening wedge distal femoral varus osteotomy with Puddu plate fixation can be a reliable procedure for the treatment of lateral compartment osteoarthritis of the knee associated with valgus deformity.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Arthroscopy and Sports Injuries Unit, Hasharon Hospital, Rabin Medical Center, 7 Keren Kayemet St, 49372, Petach-Tikva, Israel

    Rafael Thein, Shlomo Bronak & Barak Haviv

  2. Department of Orthopedics, Sheba Medical Center, Tel-Hashomer, Israel

    Ran Thein

  3. Orthopedic Department, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel

    Rafael Thein & Barak Haviv

Authors
  1. Rafael Thein
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  2. Shlomo Bronak
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  3. Ran Thein
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  4. Barak Haviv
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Corresponding author

Correspondence to Barak Haviv.

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Thein, R., Bronak, S., Thein, R. et al. Distal femoral osteotomy for valgus arthritic knees. J Orthop Sci 17, 745–749 (2012). https://doi.org/10.1007/s00776-012-0273-1

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  • DOI: https://doi.org/10.1007/s00776-012-0273-1

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