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Orthopedics, 2013;21(4):437–440
Published Online:https://doi.org/10.3928/0147-7447-19980401-08Cited by:75

Abstract

ABSTRACT

Twenty-one patients with lateral compartment osteoarthritis and valgus deformity of the knee underwent distal femoral supracondylar osteotomy (medial closing wedge) between 1 983 and 1 993 with followup ranging from 1 to 8 years. Ten knees had plastercast immobilization, 5 had fixation with 2 staples supplemented with a plaster cast, and 6 knees had rigid internai fixation with an AO blade plate.

Thirty-three percent of patients had a satisfactory result using the HSS score, and 57% had a satisfactory result using the Knee Society Clinical Rating. Fifty-seven percent had a significant complication, including severe knee stiffness requiring manipulation under anesthesia (48%), nonunion/delayed union (19%), infection (1 0%), and fixation failure (5%). Five (1 9%) knees required total knee replacement within 5 years of surgery.

Satisfactory results were obtained only in those patients who had less severe degrees of osteoarthritis confined to the lateral compartment (grades I to III), adequate correction of valgus deformity (the anatomical axis within 2° from zero), and rigid internal fixation to permit postoperative early mobilization. These results indicate that distal femoral osteotomy is a satisfactory procedure in the young, active patient with osteoarthritis of the lateral compartment of the knee, but requires precise surgical technique and rigid internal fixation.

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