Closing-wedge low femoral osteotomy: Functional outcomes of 47 cases after 6.5 years follow-up in a low-income country

Abstract

Introduction: Distal femoral varus osteotomy (DVO) allows for the surgical management of uni-compartmental femoral-tibial gonarthrosis on knee valgum after failure of medical treatment. The aim of this study was to evaluate the functional results of this therapeutic approach at the Saint Jean de Dieu Hospital in Afagnan. Patients and Method: This is a retrospective, single-center study conducted from January 2006 to December 2018 on patients who presented with gonarthrosis with disabling knee valgum. Osteosynthesis was performed using AO blade-plates bent at 90°. The patients were reviewed and the evolution and complications were recorded. Results: Forty-seven patients had been treated surgically by the medial closure varus femoral osteotomy technique. They were 32 women and 14 men with an average age of 55.45 years (25-72 years). Twenty-six patients had AHLBACK stage III femorotibial gonarthrosis and 5 patients had stage IV. Twenty-six patients also had associated patellofemoral osteoarthritis. All patients consolidated with a mean time of 95 days (90-125). No pseudarthrosis or postoperative infection was observed. We recorded one case of osteosynthesis failure (material rupture) resumed by a dynamic DCS compression screw. Conclusion: Femoral varus osteotomy by medial closure remains today an alternative of choice in the management of gonarthrosis with associated knee valgum in our context.