[Distal femoral osteotomy using a lateral opening wedge technique].

Abstract:

OBJECTIVE:To shift the weight-bearing axis of the lower limb medially by opening a lateral-based metaphyseal osteotomy at the distal femur. INDICATIONS:Femoral-based valgus malalignment and symptomatic lateral unicompartimental osteoarthritis, lateral hyperpression syndrome, cartilage therapy of the lateral compartment, lateral meniscal replacement/transplantation, medial instability with valgus thrust, reconstruction of the medial collateral ligament, patellar instability and/or maltracking. CONTRAINDICATIONS:Advanced cartilage damage (>grade 2) or subtotal meniscal loss of the medial compartment, age >65 years (relative), nicotine abuse, body mass index >30, flexion contracture >25°, corrections with a wedge base >10 mm in case of congenital deformities, inflammatory or septic arthritis, severe osteoporosis. SURGICAL TECHNIQUE:Lateral approach to the distal femur; biplanar osteotomy (frontal + axial osteotomy), gradual opening of the osteotomy, osteotomy fixation with a locking plate. POSTOPERATIVE MANAGEMENT:Free range of motion. Partial weight bearing with 20 kg for 2 weeks, followed by progressive weight bearing thereafter. RESULTS:Mean improvement of knee scores from 20-30 points and mean 10-year survival rate of 80% in patients with lateral unicompartimental osteoarthritis. Mean complication rate of 9%.

journal_name

Oper Orthop Traumatol

authors

Feucht MJ,Mehl J,Forkel P,Imhoff AB,Hinterwimmer S

doi

10.1007/s00064-017-0503-y

subject

Has Abstract

pub_date

2017-08-01 00:00:00

pages

320-329

issue

4

eissn

0934-6694

issn

1439-0981

pii

10.1007/s00064-017-0503-y

journal_volume

29

pub_type

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