Closing wedge distal femoral osteotomy for knee valgus: indications, technique, rehabilitation and outcomes
Introduction: In cases of symptomatic knee valgum, in which deformity majorly originated in the femoral distal metaphysis, 2 main types of femoral osteotomy have been described: medial closing or lateral opening. We have been doing medial closing wedges with anterior second plane cut for years. The...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-03-01
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| Series: | Journal of Cartilage & Joint Preservation |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667254523000124 |
| _version_ | 1827987190342221824 |
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| author | Jae-Sung An Kristian Kley Christophe Jacquet Levi Reina Fernandes Matthieu Ollivier |
| author_facet | Jae-Sung An Kristian Kley Christophe Jacquet Levi Reina Fernandes Matthieu Ollivier |
| author_sort | Jae-Sung An |
| collection | DOAJ |
| description | Introduction: In cases of symptomatic knee valgum, in which deformity majorly originated in the femoral distal metaphysis, 2 main types of femoral osteotomy have been described: medial closing or lateral opening. We have been doing medial closing wedges with anterior second plane cut for years. The reason being a proven similar surgical accuracy associated to a higher and faster healing rate promoted by a larger contact area between the 2 sides of the osteotomy site. The aim of this article is to describe up-to-date closing wedge distal femoral osteotomy strategies: from indication, to ideal correction, surgical technique and patient recovery. Methods: Distal femoral varus osteotomy is indicated in painful valgus knee in which deformity originated majorly in the femoral distal metaphysis. The planning is digitally performed according to the Miniaci method using digital software to have a postoperative weight bearing line passing through the knee joint at 45% to 50% measured from the medial tibial plateau border (0%) to the lateral tibial plateau border (100%). The procedure is performed through medial closing wedges created with 2 medial to lateral and 1 posterior to anterior cutting planes creating an anterior biplanar cut. Results: Using our step-by-step way to perform closing wedge distal femoral osteotomy, we standardized our radiological and clinical outcomes. Knowing some tips and tricks to avoid intraoperative complications will help readers to master this procedure. Conclusions: Following simple intraoperative landmark and technical guidance bony deformity can be fully corrected by medial closing wedges using an anterior biplanar cut. Patients will demonstrate optimal clinical outcomes including high rate of return to recreational and professional activities. |
| first_indexed | 2024-04-09T23:42:57Z |
| format | Article |
| id | doaj.art-b0761a05b2764f0687779bc4f8a0b8ed |
| institution | Directory Open Access Journal |
| issn | 2667-2545 |
| language | English |
| last_indexed | 2024-04-09T23:42:57Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Cartilage & Joint Preservation |
| spelling | doaj.art-b0761a05b2764f0687779bc4f8a0b8ed2023-03-18T04:43:09ZengElsevierJournal of Cartilage & Joint Preservation2667-25452023-03-0131100110Closing wedge distal femoral osteotomy for knee valgus: indications, technique, rehabilitation and outcomesJae-Sung An0Kristian Kley1Christophe Jacquet2Levi Reina Fernandes3Matthieu Ollivier4Tokyo Medical and Dental University, Tokyo, JapanOrthoprofis, Hannover, GermanyInstitut du Mouvement et de l'Appareil Locomoteur, Marseille, FranceHospital CUF Santarém, Santarém, PortugalInstitut du Mouvement et de l'Appareil Locomoteur, Marseille, France; Matthieu Ollivier, Institut du Mouvement et de l'Appareil Locomoteur, Hôpital Sainte-Marguerite, Aix-Marseille Université, 270, Boulevard Sainte-Marguerite, 13009 Marseille, France.Introduction: In cases of symptomatic knee valgum, in which deformity majorly originated in the femoral distal metaphysis, 2 main types of femoral osteotomy have been described: medial closing or lateral opening. We have been doing medial closing wedges with anterior second plane cut for years. The reason being a proven similar surgical accuracy associated to a higher and faster healing rate promoted by a larger contact area between the 2 sides of the osteotomy site. The aim of this article is to describe up-to-date closing wedge distal femoral osteotomy strategies: from indication, to ideal correction, surgical technique and patient recovery. Methods: Distal femoral varus osteotomy is indicated in painful valgus knee in which deformity originated majorly in the femoral distal metaphysis. The planning is digitally performed according to the Miniaci method using digital software to have a postoperative weight bearing line passing through the knee joint at 45% to 50% measured from the medial tibial plateau border (0%) to the lateral tibial plateau border (100%). The procedure is performed through medial closing wedges created with 2 medial to lateral and 1 posterior to anterior cutting planes creating an anterior biplanar cut. Results: Using our step-by-step way to perform closing wedge distal femoral osteotomy, we standardized our radiological and clinical outcomes. Knowing some tips and tricks to avoid intraoperative complications will help readers to master this procedure. Conclusions: Following simple intraoperative landmark and technical guidance bony deformity can be fully corrected by medial closing wedges using an anterior biplanar cut. Patients will demonstrate optimal clinical outcomes including high rate of return to recreational and professional activities.http://www.sciencedirect.com/science/article/pii/S2667254523000124Knee osteotomyArthritisKnee valgumDistal femoral osteotomyAlignment |
| spellingShingle | Jae-Sung An Kristian Kley Christophe Jacquet Levi Reina Fernandes Matthieu Ollivier Closing wedge distal femoral osteotomy for knee valgus: indications, technique, rehabilitation and outcomes Journal of Cartilage & Joint Preservation Knee osteotomy Arthritis Knee valgum Distal femoral osteotomy Alignment |
| title | Closing wedge distal femoral osteotomy for knee valgus: indications, technique, rehabilitation and outcomes |
| title_full | Closing wedge distal femoral osteotomy for knee valgus: indications, technique, rehabilitation and outcomes |
| title_fullStr | Closing wedge distal femoral osteotomy for knee valgus: indications, technique, rehabilitation and outcomes |
| title_full_unstemmed | Closing wedge distal femoral osteotomy for knee valgus: indications, technique, rehabilitation and outcomes |
| title_short | Closing wedge distal femoral osteotomy for knee valgus: indications, technique, rehabilitation and outcomes |
| title_sort | closing wedge distal femoral osteotomy for knee valgus indications technique rehabilitation and outcomes |
| topic | Knee osteotomy Arthritis Knee valgum Distal femoral osteotomy Alignment |
| url | http://www.sciencedirect.com/science/article/pii/S2667254523000124 |
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