Distal Femoral Osteotomy
Distal Femoral Osteotomy
Several authors have identified a postoperative HKA of three–5° valgus or a mechanical axis at sixty two–66% of the tibial width as optimum in medial OA . Recently studies contemplate the extent of medial chondromalacia and perform an individually adjusted correction with a more reasonable focused vary of valgus (HKA 1.7–5° or 50–sixty five% of the entire tibial plateau width), while avoiding overcorrection . A knee joint arthroscopy is really helpful in the same session, for addressing intraoperative pathologies and fine-tuning of correction, depending on the sort and extent of intraarticular injury .
Through appropriate indication and affected person choice, each sorts of valgisation osteotomies close to the knee joint can present improvements in medical operate, pain degree and quality of life. These joint-preserving interventions thus characterize a useful remedy possibility in varus deformities. Varus deformities of the knee are regularly corrected by osteotomies, which must be carried out at the level of origin. But in contrast to high tibial osteotomies , little data exists for distal femoral osteotomies . An Osteotomy is a controlled surgical break or fracture of the bone to permit realignment of the limb.
Femoral Distal Opening And Closing Wedge Osteotomy :
Diagnostic arthroscopy can be used to assess for related meniscoligamentous or cartilage injuries for concomitant procedures with the osteotomy. The denoted structures represent the lateral femoral condyle , the lateral meniscus , and the lateral tibial plateau . The objective of surgery is to re-create neutral alignment, such that the mechanical axis line passes via the middle of the knee.three The amount of correction is calculated based on the angle shaped between the mechanical axis of the femur and tibia . Practically, 5 levels of malalignment is the edge to contemplate osteotomy.
- The approach offered in this article offers a safe, reproducible technique to carry out the medial closing-wedge DFO.
- Corticocancellous wedges are harvested from the femoral neck portion of an allograft femoral head and placed into the osteotomy site based on the preoperative plan.
- Among them, Salter-Harris sort II is the most common, making up about half of growth plate fractures, whereas varieties IV and V are rare, accounting for only some p.c .
- The diaphyseal midline was marked with an electrocautery and a Codman pen to avoid angular deviation during the stabilization of the plaque.
Bone fusion is achieved and %MA is forty eight.5% from the medial edge of the tibial plateau. Severe valgus deformity is noted with an FTA of a hundred and sixty degrees and a %MA of 100% from the medial fringe of the tibial plateau. Limitations of this examine are the heterogeneous study inhabitants and the low case number for femoral and tibial osteotomies. The anticipated number of circumstances within this cohort and the imply values and normal deviations in accuracy and scientific outcome parameters in earlier studies have been too small for a potential power evaluation. Additionally, lengthy-term information about medical operate or survival charges is lacking. Several authors report an enchancment of scientific scores for as much as 5 years postoperatively after HTO.