4Shafa Orthopedic Hospital, Iran University of Medical
Sciences, Tehran, Iran
Background: Distal femur wedge osteotomies for varus or valgus alignment of the lower extremity could be done in either uniplanar or biplanar fashion.Union time and stability of the osteotomy site has been considered important in this anatomic region. In this study, clinical and radiographic findings of biplane distal femur osteotomy were reported. Methods: Clinical, functional, and radiological findings of eight patients (10 knees)underwent biplane distal femur osteotomy were evaluated. Visual analogue score (VAS) and Lysholm-Tegner knee score were used for the assessment of pain and function before and three months after surgery. Results: In this study, eight patients were included. All patients were female. The mean age was 28±6.3. The mean pre-operativemechanical anglewas 8.7±2.2˚and the post-operativeangle was 1.4±0.53˚ in patients with valgus alignment whileit was 7.0±1.0˚preoperatively and 0.66±1.2˚ postoperatively in patients with varus alignment. The mean lateral distal femoral angle (LDFA)was 85±8.0˚ before surgery and was 88±1.3˚ after surgery. According to Lysholm- Tegner knee score, in the post-operative visit, sixknees were good and four were excellent. The mean union time was 9.2±2.3 weeks. Conclusions: Biplane distal femur osteotomy is a reliable technique that creates larger surfaces and more stability at the osteotomy site with further rapid union.
Das DH, Sijbesma T, Hoekstra H, van Leeuwen WM. Distal femoral opening-wedge osteotomy for lateral compartment osteoarthritis of the knee. Open Access Surgery. 2008; 1:25-9.
Lobenhoffer P, Van Heerwaarden RJ, Staubli AE, Jakob RP, Galla M, Agneskirchner JD. Osteotomies around the knee: Indications-Planning-Surgical Techniques using Plate Fixators. New York: Thieme; 2009.
Minas T. A Primer in Cartilage Repair and Joint Preservation of the Knee: Expert Consult. Netherlands: Elsevier Health Sciences; 2011. p:146-59.
Stähelin T, Hardegger F, Ward JC. Supracondylar osteotomy of the femur with use of compression. Osteosynthesis with a malleable implant. .J Bone Joint Surg Am. 2000; 82(5):712-22.
Stähelin T, Hardegger F. Incomplete, supracondylar femur osteotomy. A minimally invasive compression osteosynthesis with soft implant. Orthopade. 2004; 33(2):178-84.
van Heerwaarden R, Wymenga A, Freiling D, Lobenhoffer P. Distal medial closed wedge varus femur osteotomy stabilized with the Tomofix plate fixator. Operat techn Orthop. 2007; 17(1):12-21.
Cameron HU, Botsford DJ, Park YS. Prognostic factors in the outcome of supracondylar femoral osteotomy for lateral compartment osteoarthritis of the knee. Can J Surg. 1997;40(2):114-8.
Brinkman JM, Hurschler C, Agneskirchner J, Freiling D, Van Heerwaarden R. Axial and torsional stability of supracondylar femur osteotomies: biomechanical comparison of the stability of five different plate and osteotomy configurations. Knee Surg Sports Traumatol Arthrosc. 2011; 19(4):579-87.
Brinkman JM, Hurschler C, Staubli A, van Heerwaarden R. Axial and torsional stability of an improved single-plane and a new bi-plane osteotomy technique for supracondylar femur osteotomies. Knee Surg Sports Traumatol Arthrosc. 2011; 19(7):1090-8.
van Heerwaarden R, Najfeld M, Brinkman M, Seil R, Madry H, Pape D. Wedge volume and osteotomy surface depend on surgical technique for distal femoral osteotomy. Knee Surg Sports Traumatol Arthrosc. 2013; 21(1):206-12.
Jackson JP, Waugh W. Tibial osteotomy for osteoarthritis of the knee. Proc R Soc Med. 1960; 53(10):888.
Freiling D, van Heerwaarden R, Staubli A, Lobenhoffer P. Die varisierende Closed-Wedge-Osteotomie am distalen Femur zur Behandlung der unikompartimentalen lateralen Arthrose am Kniegelenk. Operative Orthopädie und Traumatologie. 2010; 22(3):317-34.