Distal Femoral Osteotomy Seattle, Wa
In this article, we describe our most popular operative technique for a lateral opening wedge varus-producing distal femoral osteotomy to right gentle to average valgus malalignment. Video 1 The video describes our preferred technique for lateral opening wedge distal femoral osteotomy. PearlsRadiolucent retractors permit fluoroscopic visualization while the osteotomy is carried out.The surgeon should mark the saw 5-10 mm shorter than the size of the wire to keep away from plunging and violating the lateral cortex. Two separate marks may be used to correspond to the lengths of the anterior and posterior wires, respectively.Gentle and/or slow closing of the osteotomy hole should be carried out to keep away from fracture of the lateral cortex.
For a medial closing wedge osteotomy, a wedge-shaped part of bone is eliminated, and the opening is closed by bringing the minimize ends of the bones together, thus altering the alignment of the bones. We have discovered that performing the distal femoral osteotomy and the MCL reconstruction at the identical time is successful and does not require two separate reconstructions. Calculations of the precise amount of opening that’s wanted utilizing the current digital x-ray techniques are very correct. Concurrent with this, a plate and screws are positioned on the surface of the knee and bone graft is positioned into the opening wedge which is created to assist with therapeutic of the gap. The wedge dimension can be planned earlier than surgery and confirmed intraoperatively.
Femoral Distal Opening And Shutting Wedge Osteotomy :
Diagnostic arthroscopy can be utilized to assess for related meniscoligamentous or cartilage injuries for concomitant procedures with the osteotomy. The denoted buildings symbolize the lateral femoral condyle , the lateral meniscus , and the lateral tibial plateau . The goal of surgical procedure is to re-create neutral alignment, such that the mechanical axis line passes by way of the center of the knee.3 The quantity of correction is calculated based on the angle fashioned between the mechanical axis of the femur and tibia . Practically, 5 degrees of malalignment is the edge to think about osteotomy.
- There had been no related variations in hospital stay, blood loss or surgery time.
- The technique presented on this article offers a safe, reproducible methodology to perform the medial closing-wedge DFO.
- The success charges for lateral meniscal transplants and cartilage resurfacing procedures are a lot less if the valgus alignment is not corrected with the surgical process .
- Corticocancellous wedges are harvested from the femoral neck portion of an allograft femoral head and placed into the osteotomy web site according to the preoperative plan.
- The diaphyseal midline was marked with an electrocautery and a Codman pen to avoid angular deviation in the course of the stabilization of the plaque.
Bone fusion is achieved and %MA is 48.5% from the medial fringe of the tibial plateau. Severe valgus deformity is famous with an FTA of one hundred sixty levels and a %MA of a hundred% from the medial fringe of the tibial plateau. Limitations of this examine are the heterogeneous study population and the low case quantity for femoral and tibial osteotomies. The anticipated number of cases within this cohort and the mean values and commonplace deviations in accuracy and medical consequence parameters in previous studies had been too small for a prospective energy analysis. Additionally, lengthy-time period details about clinical operate or survival rates is missing. Several authors report an enchancment of clinical scores for as much as 5 years postoperatively after HTO.
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