Distal femoral osteotomy using a lateral opening wedge technique

Abstract

To shift the weight-bearing axis of the lower limb medially by opening alateral-based metaphyseal osteotomy at the distal femur. 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. Advanced cartilage damage (>grade2) or subtotal meniscal loss of the medial compartment, age >65years (relative), nicotine abuse, body mass index >30, flexion contracture >25°, corrections with awedge base >10 mm in case of congenital deformities, inflammatory or septic arthritis, severe osteoporosis. Lateral approach to the distal femur; biplanar osteotomy (frontal+ axial osteotomy), gradual opening of the osteotomy, osteotomy fixation with alocking plate. Free range of motion. Partial weight bearing with 20 kg for 2weeks, followed by progressive weight bearing thereafter. Mean improvement of knee scores from 20-30points and mean 10-year survival rate of 80% in patients with lateral unicompartimental osteoarthritis. Mean complication rate of 9%.