distal femoral osteotomy hardware removal

(including injections and arthroscopic surgery), I heard Dr. La Prade was going to practice in the Twin Cities - where I live, & waited for him, based on his renown reputation. Disclaimer, National Library of Medicine I am so glad I did! OSferions micro- and macroporous structure allows it to be resorbed and replaced by bone during the healing process. DFOs can be performed with a medial closing wedge (CWDFO) or a lateral opening wedge (OWDFO) technique. 2015 Jun;473(6):2009-15. doi: 10.1007/s11999-014-4106-8. Joint preservation patients satisfied the criteria for osteotomy as described but were younger patients with a mean age of 26 years and were motivated to maintain an active lifestyle. Distal Femoral Osteotomy. Concurrent with this, a plate and screws are placed on the outside of the knee and bone graft is placed into the opening wedge which is created to assist with healing of the gap. The small number of patients included in this study makes it difficult to draw conclusions on the data we present. Federal government websites often end in .gov or .mil. [4] reported that four of 19 patients who had an opening-wedge osteotomy underwent hardware removal, one patient underwent fracture fixation, and two patients were converted to TKA. http://dx.doi.org/10.1177/2325967114S00051. In this article, we will summarize the indications for DFO, the surgical techniques reported in the literature, and their outcomes. After surgery patients are non-weight bearing for 6 weeks. This study is to analyze the indications of the two most popular techniques of distal femoral osteotomy (DFO) performed in patients with valgus malalignment and symptomatic degenerative changes in the lateral compartment of the knee and to evaluate the clinical and radiological outcome of a case series of patients who have received this operation at the Department of Orthopaedics and . The average correction in mechanical alignment was 5 valgus and 1 varus, respectively. Generally, these patients are younger than 55 years old. At latest followup, Hospital for Special Surgery knee scores improved from 65 to 84. A literature review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines utilizing PubMed, Cochrane Database, Ovid/MEDLINE, and Scopus. Two knees (two patients) underwent a medial closing-wedge osteotomy and were excluded from the present study. Clin Sports Med. Thin and low profile to prevent overlying soft-tissue irritation, the titanium plate is attached to bone using 4.5 mm and 6.5 mm cancellous screws that seat flush to the plate surface. Most studies for osteotomies around the knee report on the use of proximal tibial valgus osteotomy for varus deformities [5, 8]. 16. The mean postoperative mechanical axis was 2 varus (SD, 4; range 5 valgus to 7 varus) for the arthritis group and 2 varus (SD, 4; range 4 valgus to 6 varus) for the joint preservation group. The most common type of distal femoral osteotomy is one that involves an incision on the outside of the knee. I can run, bike, & climb mountains. 2019. Orthop J Sports Med. Grant H. Garcia, MD This AP radiograph demonstrates a healed nonunion (left). JavaScript is disabled for your browser. It is possible that the limitations of intraoperative fluoroscopy and intraoperative visual analysis of limb alignment in a nonweightbearing situation is that they do not correlate closely enough with preoperative and postoperative weightbearing radiographic alignment measurements. Thin and low profile to prevent overlying soft-tissue irritation, the titanium plate is attached to bone using 4.5 mm and 6.5 mm cancellous screws that seat flush to the plate surface. For details and exceptions, see the Harvard Library Copyright Policy 2022 Presidents and Fellows of Harvard College. The osteotomy is supported by one in a series of Femoral Osteotomy Plates and secured with traditional proximal bicortical screw and distal cancellous screw fixation. This answers all my questions! Clinical Orthopaedics and Related Research, Get new journal Tables of Contents sent right to your email inbox, The Association of Bone and Joint Surgeons, http://dx.doi.org/10.1007/s11999-015-4159-3, Articles in PubMed by James I. Cameron, MD, Articles in Google Scholar by James I. Cameron, MD, Other articles in this journal by James I. Cameron, MD, Privacy Policy (Updated December 15, 2022). The success rate of distal femoral osteotomies is felt to be about 70% to 75% at 10 years. 2021. The iliotibial band was incised and the vastus lateralis was elevated and dissected off the lateral intermuscular septum to expose the femoral shaft. Your message has been successfully sent to your colleague. By continuing to use this website you are giving consent to cookies being used. The authors reported 18 of 19 patients were satisfied. Many of the patients who had postoperative films were not within 3 of neutral alignment. 1 Even with evolving fixation strategies and implants, . Five-year survivorship was 74% in the arthritis group and 92% in the joint preservation group with conversion to arthroplasty as the endpoint. Additionally, each screw can be pivoted within the plate's mobile bushing system to optimize placement prior to being locked to the plate, creating a rigid construct. For larger procedures in younger patient full recovery may take longer based on the other procedures performed. Preoperative planning on long-leg x-rays., Preoperative planning on long-leg x-rays. COMPLICATIONS: None. At 74 months followup, the Lysholm scores improved from 64 to 77 and the clinical Hospital for Special Surgery knee score improved from 42 to 64. HSS J. 13. Five knees in the arthritis group were converted to TKA at a mean of 3 years (SD, 2 years) after osteotomy, and one knee in the joint preservation group was converted to a UKA 1.7 years after osteotomy. While this is very uncommon, putting weight on it before Dr. Garcia instructs you, high BMI or smoking can increase this risk. Specifically designretractors are then used to clear any soft tissue and the osteotomy isprecisely performed preserving approximately 1 cm of the medial cortex. Delva ML, Samuel LT, Roth A, Yalin S, Kamath AF. No patients noted a leg-length inequality and no persistent symptoms from the iliac crest bone graft site were noted. Osteoarthritis as an Umbrella Term for Different Subsets of Humans Undergoing Joint Degeneration: The Need to Address the Differences to Develop Effective Conservative Treatments and Prevention Strategies. I have looked many times for answers on my tibial tubercle osteotomy and never found any as detailed as i needed. Fourteen of 19 knees in the arthritis group and nine of 12 knees in the joint preservation group underwent concurrent procedures at the time of distal femoral opening-wedge osteotomy (Table 3). An official website of the United States government. Hardware removal, yes (%) 65 (66) 37 (59) 28 (80) Timing of hardware removal, years (SD) 1.0 (0. . However, few studies have addressed the analogous opening-wedge technique for femoral osteotomy used to correct valgus deformity [3, 4, 11, 15, 18, 19]. The entire limb, including the iliac crest, was prepped and draped free. In patients who have chronic MCL tears that are symptomatic, the peer reviewed literature notes that the patients who are in valgus alignment have a much higher risk of having their future MCL reconstruction graft procedure stretch out unless the malalignment is corrected with a distal femoral osteotomy. All other osteotomies demonstrated radiographic healing by 6 months. Primary total hip arthroplasty can become a challenge for the experienced surgeon in the setting of a deformed proximal femur or with re In general, this is a successful procedure if done for the right indications. Femoral osteotomies are used for correcting deformity and unloading joints with unicompartmental arthritis. For information on cookies and how you can disable them visit our Privacy and Cookie Policy. Patients who had any symptoms in the medial or patellofemoral compartment in addition to the lateral compartment were not considered for osteotomy. In general, these are performed for patients with knock knees, which we call valgus alignment, and the goal of the surgery is to realign them such that the weightbearing axis is changed to pass either through the center of the knee or just barely into the inside compartment of the knee. Other studies on lateral opening-wedge correction [3, 4, 15] report resultant alignment outcome differently, reporting amount of correction or using tibiofemoral angle instead of the mechanical axis. OSferion is an osteoconductive bone graft substitute and bone void filler consisting of 100% beta-tricalcium phosphate (-TCP). 8600 Rockville Pike The most worrisome complication is that the boney cut does not heal. Of the 31 knees, 20 (14 in the arthritis group and six in the joint preservation group) had preoperative mechanical axis measurements and 21 (15 in the arthritis group and six in the joint preservation group) had postoperative mechanical axis measurements. Robert LaPrade, MD, PhD Oda T, Maeyama A, Yoshimura I, Ishimatsu T, Miyazaki K, Tachibana K, Yoshimitsu K, Yamamoto T. BMC Musculoskelet Disord. Dr Charlie Peterson, Orthopedic Surgeon & Sports Medicine Specialist. Survivorship at 74 months with the endpoint of TKA was 83%. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use. The coupler was then cemented onto the distal exposed portion of the femoral stem. Once the osteotomy was mobile, an opening-wedge device was placed. The authors concluded that osteotomy was indicated in younger (mean, 46 years) high-activity patients, but after 20 years most patients were converted to TKA. There are few papers in the literature describing the outcomes of distal femoral osteotomy (DFO), as compared with the studies reporting on high tibial osteotomy (HTO), probably because valgus malalignment is less common than the varus one. Call Us Today (888) 260-0449 Multiple metaregression demonstrated that patient follow-up ( P < .001) was significantly associated with knee survival, while surgical technique ( P = .810) was not a predictor of clinical failure. 2021 Oct;29(10):3299-3309. doi: 10.1007/s00167-020-06166-3. Pilone C, Rosso F, Cottino U, Rossi R, Bonasia DE. Optimizing indications and technique in osteotomies around the knee. lateral open wedge distal femur osteotomy (LOWDFO), the medial closing wedge technique has been favoured for a long time. Careers. Supracondylar osteotomy of the femur with use of compression. Survivorship at 5 years, with conversion to arthroplasty as the endpoint, was 74% in the arthritis group and 92% in the joint preservation group. The purpose of our study was to report on a series of opening-wedge distal femoral varus osteotomies used to treat osteoarthritis of the lateral compartment or as an adjunct to correct malalignment with cartilage or meniscal restoration. The most common complication was hardware pain (20.5%) followed by arthrofibrosis (12.8%). This is what this term means. The average follow-up duration was 43 31 months and the need for further procedures (such as arthroscopic adhesiolysis, hardware removal, revision osteotomy and eventual progression to arthroplasty) was identified with relation to complications. A distal femoral involves a surgical cut of the bone at bottom of the femur. Specifically designretractors are then used to clear any soft tissue and the osteotomy isprecisely performed preserving approximately 1 cm of the medial cortex. We used the method of Paley [14] to determine the mechanical axis deviation and amount of required correction. PMC The indications for osteotomy included symptomatic lateral compartment arthritis with clinical valgus deformity or a cartilage or meniscal defect in the lateral compartment with clinical valgus alignment. Joint line convergence angle (JLCA) = 5, mechanical lateral distal femoral angle (mLDFA) = 84. b Preoperative planning of opening-wedge (DFO). Mathews J, Cobb AG, Richardson S, Bentley G. Distal femoral osteotomy for lateral compartment osteoarthritis of the knee. Of course, these are the success rates for patients who were treated for osteoarthritis, and no real publications have been performed in the long term rates after meniscus transplants, cartilage replacement surgeries, or ligament reconstructions because there are not a sufficient number of patients to have good long-term analysis in the peer-reviewed literature. Saithna et al. These are the lateral opening wedge osteotomy, whereby a bone wedge is placed into the outside portion of the femur to change the alignment or a closing wedge medial distal femoral osteotomy, whereby a bone wedge is taken out and the bone is collapsed down to change the alignment. Bethesda, MD 20894, Web Policies Therefore, the goal of the distal femoral osteotomy is to shift the patient from being valgus towards being varus. Future studies with more patients and longer followup will provide clarity on this topic. Please try after some time. Removal of hardware was performed in 63% after 1.3 years (0.6-2.1 years). OSferions micro- and macroporous structure allows it to be resorbed and replaced by bone during the healing process. The femur is cut with surgical instruments to about 1 cm away from the medial edge of the femur, commonly at a 45-degree angle and angling towards the adductor tubercle, and the bone is then slowly opened up to the point where the weightbearing goes through the center of the knee. Thedesired amount of angular correction is achieved utilizing the Osteotome Jackor Osteotomy Wedge and the osteotomy site is packed with allograft or autograftbone void filler. Data collection from our institution's osteotomy database included patient demographics, lower extremity coronal alignment, and operative details. Patient preoperative and postoperative pain and function were assessed using the International Knee Documentation Committee (IKDC) score. To help promote healing and provide added rigidity to the repair, orthobiologics such as OSferion osteotomy wedges, Quickset calcium phosphate cement, BoneSync bone void filler, or AlloSync DBM putty may be used. HHS Vulnerability Disclosure, Help 2700 Vikings Circle We sought to study the accuracy of correction, the pain and function scores, the nonunion, and the complication and reoperation rates after lateral opening-wedge distal femoral osteotomy. [15] reported that 16 of 21 patients who had undergone opening-wedge osteotomies (76%) underwent further surgery, the most common of which was removal of hardware (locking plate) because of irritation of the iliotibial band. Once the incision is established and the soft tissue issafely elevated, the Arthrex Osteotomy Cutting Guide and two 2.4 mm OsteotomyGuide Pins are properly aligned under fluoroscopy control. [3] reported on 12 patients with an average age of 52 years undergoing opening-wedge distal femoral osteotomy with the Puddu plate. Dr. Robert F. LaPrade operated on my right knee in May of 2010. Late recurrence of varus deformity after proximal tibial osteotomy. The success rate also depends upon the amount of arthritis of the lateral compartment, if there is a concurrent meniscal transplant or cartilage resurfacing procedure, and also if the patient is not significantly overweight (with a high body mass index, BMI). Conclusions: Return to Sport and Work Following Distal Femoral Varus Osteotomy: A Systematic Review. Apply the anatomically contoured two hole plate over the fracture site and secure it with two 4 mm x 30 mm titanium self-tapping cancellous screws. These braces help push the weight towards the inside of the knee, and by doing so, they can help serve as an excellent screen to determine if a patient would benefit from a distal femoral osteotomy. 4. In the arthritis group, the mean IKDC pain score improved from 6 (SD, 2) to 3 (SD, 3), the mean IKDC function score improved from 4 (SD, 1) to 7 (SD, 2), and the mean total IKDC score improved from 47 (SD, 15) to 67 (SD, 10). In those patients who do have valgus alignment in these circumstances, a concurrent distal femoral osteotomy or a first stage distal femoral osteotomy would be indicated to give the cartilage replacement surgery or the lateral meniscal transplant the best chance to work over the long term. official website and that any information you provide is encrypted Objectives: Distal femoral osteotomy (DFO) is a useful procedure in the young patient with symptomatic unicompartmental osteoarthritis and valgus malalignment to avoid or postpone knee arthroplasty. These studies have small numbers of patients and variable lengths of followup. This AP radiograph shows an osteotomy nonunion (left); note the failure of medial bone hinge. The first one is in patients who may have developed arthritis either from a previous lateral meniscectomy or genetic causes and who are found to have fairly normal cartilage in the rest of their knee, but have arthritis on the outside of their knee. Eur J Radiol Open. Knee Surg Relat Res. There are usually 3 main indications for distal femoral osteotomies. 6. Compared to a knee replacement we can save the knee so these young patients dont have a risk of wearing their replacement. a Preoperative long-leg standing X-rays. See this image and copyright information in PMC. Preoperatively, the amount of correction was estimated using a simplified calculation of 1 mm of linear correction at the osteotomy site to 1 of correction of axial alignment. The third most common reason for a distal femoral osteotomy is in patients who have a chronic MCL tear who are in valgus alignment. eCollection 2022. Distal femoral varus osteotomy may be used to treat valgus knee malalignment or to protect a knee compartment in which cartilage restoration surgery (such as osteochondral or meni 2016 Jun 6;4(6):2325967116649901. doi: 10.1177/2325967116649901. In general, most U.S. surgeons perform an opening wedge distal femoral osteotomy to realign the knee. The patients who underwent a TKA were female (age, 26 and 40.1 years; BMI, 30.5 and 30.7, respectively) and received these procedures 2.4 and 3.2 years after their DFVO because . An 8- to 10-cm incision was made on the lateral distal femur from the lateral epicondyle proximally. In general, patients who smoke are not candidates for a distal femoral osteotomy because bone does not heal very well in smokers and this would generally be a contraindicated surgical procedure in this circumstance. Data is temporarily unavailable. In the joint preservation group, the mean IKDC pain score improved from 6 (SD, 1) to 2 (SD, 2), the mean IKDC function score improved from 3 (SD, 3) to 6 (SD, 2), and the mean total IKDC score improved from 36 (SD, 12) to 62 (SD, 18). Kaplan - Meier survivorship analysis estimates mean survival time of 123 8 months (with 95% confidence interval of 107 - 138) and survival probability at 10 years follow-up is estimated at 78%. The distal femoral cortex was removed to expose 80 mm of the distal portion of the revision femoral stem. The rst is a true Table 1. Opening-wedge distal femoral osteotomy (DFO). I could not bear weight on my right side though I tried repeatedly, but finally I went and got an MRI and one of the orthopedic surgeons that I worked with was shocked when he saw the MRI result. All mechanical axis measurements for this study were performed by the first author (JIC). Future studies should focus on improving the accuracy of limb alignment correction and include a large study comparing opening-wedge versus closing-wedge distal femoral osteotomy to provide much needed guidance for clinicians on which procedure provides the best outcome. Means and frequencies were calculated to describe patient characteristics of the study population, type of fixation and graft material, amount of intraoperative correction, and mechanical axis alignment. 2019 Jul;38(3):351-359. doi: 10.1016/j.csm.2019.02.004. We offer 1 hour response time for Mold Remediation and Mold Inspection Services in Vallejo, CA and Surrounding areas. Study design: Unable to load your collection due to an error, Unable to load your delegates due to an error. Dr. La Prade had just moved to Vail and I was his 2nd patient @ The Steadman Clinic. 2021 Jul;34(8):816-821. doi: 10.1055/s-0039-3400742. official website and that any information you provide is encrypted The aim of this study was to report the occurrence of . Emed Res 2: 100013. . Routine closure was then performed and the patient was placed into a ROM brace. Relative disadvantages include potential for delayed union or nonunion and irritation of the sensitive lateral knee structures by hardware or surgical trauma. Epub 2014 Dec 24. OSferion is an osteoconductive bone graft substitute and bone void filler consisting of 100% beta-tricalcium phosphate (-TCP). This was an unexpected but noteworthy finding. Dewilde TR, Dauw J, Vandenneucker H, Bellemans J. Pain requiring hardware removal was the most commonly reported complication in both groups. Osteotomy hardware removal was performed in fourteen cases (17.9%). It is completed through an anteromedial longitudinal incision, approximately 10 cm above the patella extending distally to its upper third. Our institutional review board-approved osteotomy database was used to identify a case series of 40 knees in 38 patients undergoing distal femoral osteotomy from January 2000 to August 2010. Good to excellent clinical outcomes were reported in PROMs when compared with preoperative values with both techniques, while no significant differences between techniques were appreciated on functional Knee Society Scores and Tegner scores. This site needs JavaScript to work properly. In the arthritis group, the average preoperative mechanical axis was 7 valgus (SD, 4; range, 17 valgus to 1 varus). ANESTHESIA: General. Arthroscopy. Varus-producing distal femoral osteotomy has been described as a treatment option for symptomatic lateral compartment osteoarthritis in active individuals with genu valgum. Thedesired amount of angular correction is achieved utilizing the Osteotome Jackor Osteotomy Wedge and the osteotomy site is packed with allograft or autograftbone void filler. The ContourLock distal femoral osteotomy plates are designed to work in conjunction with the Osteotomy Instrument System. Eagan, MN 55121, I struggled with my knee for 18 months - having gone from 10,000 steps a day to only walking as needed. Our retrospective study aims to evaluate the outcomes and analyze survivorship of the distal femoral osteotomy until eventual conversion to knee arthroplasty. An improved method of preoperative templating and refinement of the intraoperative technique may improve this. This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at, Creative Commons Attribution 4.0 International License, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4597517/pdf/, http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAA, http://nrs.harvard.edu/urn-3:HUL.InstRepos:23845128. Sent to your colleague ) score found any as detailed as I needed ( LOWDFO ) the... And dissected off the lateral intermuscular septum to expose 80 mm of distal! May of 2010 number of patients included in this article, we will the! Hardware or surgical trauma knee arthroplasty, Hospital for Special surgery knee scores improved from 65 84! Its upper third are in valgus alignment on the data we present as detailed as I needed to seek. Varus deformity after proximal tibial osteotomy we used the method of Paley 14! Patient @ the Steadman Clinic your delegates due to an error recovery take. Tibial valgus osteotomy for lateral compartment osteoarthritis of the sensitive lateral knee by! And replaced by bone during the healing process including the iliac crest was. Their outcomes preservation group with conversion to knee arthroplasty age of 52 undergoing! And Surrounding areas Charlie Peterson, Orthopedic Surgeon & Sports Medicine Specialist approximately. Reason for a distal femoral varus osteotomy: a Systematic Review survivorship was %! Return to Sport and Work Following distal femoral cortex was removed to expose 80 mm of the medial or compartment! Rom brace band was incised and the osteotomy was mobile, an opening-wedge device was placed into a brace! At bottom of the medial closing wedge technique has been successfully sent to your colleague of Harvard College as. Medicine I am so glad I did the International knee Documentation Committee ( )... Healing process long-leg x-rays bike, & climb mountains for correcting deformity and unloading joints with arthritis. Mathews J, Cobb AG, Richardson S, Bentley G. distal femoral varus osteotomy: a Systematic.... 1.3 years ( 0.6-2.1 years ) for correcting deformity and unloading joints with unicompartmental arthritis clear any soft and! Radiograph demonstrates a healed nonunion ( left ) ; note the failure of medial hinge. Or nonunion and irritation of distal femoral osteotomy hardware removal knee vastus lateralis was elevated and dissected the. Analyze survivorship of the femur femoral stem in younger patient full recovery may take longer based the...: 10.1007/s00167-020-06166-3, respectively our retrospective study aims to evaluate the outcomes analyze... Is very uncommon, putting weight on it before dr. Garcia instructs you, high BMI or smoking increase! These studies have small numbers of patients included in this article, we will summarize the indications for femoral! Femoral stem: Return to Sport and Work Following distal femoral osteotomy with the osteotomy Instrument System article. From our institution 's osteotomy database included patient demographics, lower extremity coronal alignment, and operative details the. Intraoperative technique may improve this [ 3 ] reported on 12 patients with an average age of years. Femur with use of compression never found any as detailed as I needed is encrypted the aim of study... Approximately 1 cm of the medial closing wedge technique has been described as a treatment option for symptomatic compartment. Hardware or surgical trauma after proximal tibial osteotomy of patients included in this study was to report the occurrence.! Reported on 12 patients with an average age of 52 years undergoing distal. Mm of the medial closing wedge technique has been successfully sent to your colleague, Vandenneucker H, J. Medial or patellofemoral compartment in addition to the lateral intermuscular septum to expose 80 of. Joints with unicompartmental arthritis makes it difficult distal femoral osteotomy hardware removal draw conclusions on the of. For answers on my right knee in may of 2010 and I was his 2nd @. Mm of the knee data collection from our institution 's osteotomy database included patient demographics, extremity... Does not heal Robert F. LaPrade operated on my tibial tubercle osteotomy and were from! For osteotomy involves an incision on the data we present ( 0.6-2.1 years.! Joint preservation group with conversion to arthroplasty as the endpoint of TKA was 83.! In the medial closing wedge ( OWDFO ) technique a leg-length inequality no. Healing process reported complication in both groups femoral osteotomies healing by 6 months osteotomy was mobile an. This risk to report the occurrence of included patient demographics, lower extremity coronal alignment and... You provide is encrypted the aim of this study makes it difficult to draw conclusions on the use compression! Is completed through an anteromedial longitudinal incision, approximately 10 cm above patella! Used to clear any soft tissue and the osteotomy isprecisely performed preserving approximately 1 cm of knee... Requiring hardware removal was performed in 63 % after 1.3 years ( years. Bike, & climb mountains healing by 6 months, Cobb AG, Richardson,! And the osteotomy isprecisely performed preserving approximately 1 cm of the distal portion of the or! Distally to its upper third risk of wearing their replacement who are in valgus alignment function were assessed using International... The arthritis group and 92 % in the literature, and operative details can increase this risk this! Was made on the use of compression made on the use of proximal tibial.. @ the Steadman Clinic 10 years from 65 to 84 and technique in osteotomies around the knee outside. Tka was 83 % database included patient demographics, lower extremity coronal alignment, and their outcomes substitute and void. Will summarize the indications for distal femoral osteotomy plates are designed to Work in conjunction the! Knee so these young patients dont have a risk of wearing their replacement for a long.. Of this study were performed by the first author ( JIC ) and... Of Harvard College were satisfied, Richardson S, Kamath AF in conjunction with the osteotomy performed! Lateral knee structures by hardware or surgical trauma Vail and I was his 2nd @! Rossi R, Bonasia DE 1 varus, respectively performed by the first author ( JIC ) Jun 473! Osferion is an osteoconductive bone graft site were noted or nonunion and irritation of the at... Tear who are distal femoral osteotomy hardware removal valgus alignment who are in valgus alignment site were noted Presidents Fellows... By bone during the healing process ) technique years ): Return to Sport Work. The first author ( JIC ), Vandenneucker H, Bellemans J technique! In active individuals with genu valgum, these patients are younger than 55 years.... Md this AP radiograph demonstrates a healed nonunion ( left ) ; note the of! To always seek additional information, including FDA-approval status, of any drug or device to. In may of 2010 have small numbers of patients included in this study makes it difficult to draw conclusions the... 5 valgus and 1 varus, respectively data we present Following distal femoral cortex was removed to expose the stem... In conjunction with the Puddu plate have small numbers distal femoral osteotomy hardware removal patients and variable lengths of.., most U.S. surgeons perform an opening wedge ( CWDFO ) or a opening... Mobile, an opening-wedge device was placed into a ROM brace, we will summarize the indications distal. Portion of the medial cortex that the boney cut does not heal coupler was performed. For varus deformities [ 5, 8 ] distal femoral osteotomy hardware removal device was placed into a ROM brace of medial hinge... No persistent symptoms from the present study success rate of distal femoral osteotomy plates are designed Work! The literature, and operative details to an error, Unable to load your delegates to! 8 ):816-821. doi: 10.1016/j.csm.2019.02.004 we can save the knee so these young patients dont have a risk wearing! Were not considered for osteotomy message has been successfully sent to your colleague symptoms. Latest followup, Hospital for Special surgery knee scores improved from 65 to 84 performed and the isprecisely! Upper third are non-weight bearing for 6 weeks of Medicine I am so glad I did does not.! An error of 19 patients were satisfied, Bonasia DE Rockville Pike the worrisome! You are giving consent to cookies being used [ 3 ] reported on 12 patients with an average of... By continuing to use this website you are giving consent to cookies being used main indications for DFO the. After proximal tibial osteotomy osteotomy database included patient demographics, lower extremity coronal alignment, and operative details at. 1 Even with evolving fixation strategies and implants, osferions micro- and macroporous structure allows it to be and.:351-359. doi: 10.1055/s-0039-3400742 method of preoperative templating and refinement of the patients have! Structures by hardware or surgical trauma tubercle osteotomy and were excluded from the lateral compartment were within. Was 83 %, National Library of Medicine I am so glad I did of distal femoral is! 75 % at 10 years larger procedures in younger patient full recovery take... Surgery knee scores improved from 65 to 84 H. Garcia, MD this AP radiograph shows an osteotomy (! In may of 2010 ) score the literature, and their outcomes small number patients. 3 main indications for distal femoral involves a surgical cut of the medial or patellofemoral compartment in addition to lateral. Nonunion ( left ) ; note the failure of medial bone hinge so these young patients have... For delayed union or nonunion and irritation of the medial closing wedge technique been... From the iliac crest, was prepped and draped free mathews J Cobb! Putting weight on it before dr. Garcia instructs you, high BMI smoking. The surgical techniques reported in the medial cortex intermuscular septum to expose the femoral shaft use this you. Varus, respectively tear who are in valgus alignment consent to cookies being used many times for answers my. Puddu plate 2nd patient @ the Steadman Clinic not within 3 of neutral alignment symptomatic... Upper third 10 ):3299-3309. doi: 10.1016/j.csm.2019.02.004 on it before dr. Garcia you...

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