Ten-year minimal follow-up of lateral opening wedge distal femoral osteotomy for lateral femorotibial osteoarthritis: Good survivorship and high patient satisfaction.
conservative treatment
distal femoral osteotomy
genu valgum
knee arthroplasty
lateral tibiofemoral osteoarthritis
opening wedge
Journal
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
ISSN: 1433-7347
Titre abrégé: Knee Surg Sports Traumatol Arthrosc
Pays: Germany
ID NLM: 9314730
Informations de publication
Date de publication:
06 Aug 2024
06 Aug 2024
Historique:
revised:
23
07
2024
received:
19
04
2024
accepted:
25
07
2024
medline:
6
8
2024
pubmed:
6
8
2024
entrez:
6
8
2024
Statut:
aheadofprint
Résumé
This study aimed (1) to determine complications and survival rates of lateral opening wedge distal femoral osteotomy (LOW-DFO) in the long term, (2) to assess their clinical outcomes in the long term and (3) to identify risk factors of failure. Between 1991 and 2011, 62 LOW-DFOs were performed in the same department. Inclusion criteria were all isolated LOW-DFO performed for isolated lateral tibiofemoral osteoarthritis and valgus malalignment, with a minimum 10-year follow-up. Thirty-eight patients were included, with a mean age of 48 ± 9 years. All patients had clinical and radiological assessments. The survival curves were calculated based on the following endpoints: unicompartmental or total knee arthroplasty. The mean follow-up was 15.2 ± 4.4 [10-29] years. The mean preoperative mechanical FemoroTibial Axis (mFTA) was 188.8° ± 3.2° [184°-197°], primarily due to femur deformity (mean lateral distal femoral axis [LDFA] 83.2° ± 2.8°). Bone union was achieved in 89.5% of patients (n = 34) at a mean delay of 6.5 ± 6.7 months. The complication rate was 26% (five stiffness, one nonunion, three secondary displacements and one deep vein thrombosis). Nine revision surgeries (24%) were recorded. Survival rates at 5 and 10 years were 92.1% and 78.9%, respectively. The mean delay between DFO and total knee arthroplasty (TKA) was 11.6 ± 5.7 [1-27] years. Nineteen patients (50%) were free of TKA at the last follow-up. KSS scores were improved significantly. Return to sports was obtained in 92% of cases (n = 35), with a mean delay of 11 ± 8 months. Seventy-four per cent of patients were satisfied or very satisfied with the surgery. Eighty-four per cent would be willing to undergo the surgery again. Older age (p = 0.032) was a significant risk factor for TKA conversion. LOW-DFO is an efficient procedure to manage lateral knee osteoarthritis in young patients with valgus deformity, with a good survival rate at 10 years and high patient satisfaction. Level III.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 The Author(s). Knee Surgery, Sports Traumatology, Arthroscopy published by John Wiley & Sons Ltd on behalf of European Society of Sports Traumatology, Knee Surgery and Arthroscopy.
Références
Abdel Khalik, H., Lameire, D.L., Rubinger, L., Ekhtiari, S., Khanna, V. & Ayeni, O.R. (2022) Return to sport and work following distal femoral varus osteotomy: a systematic review. HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery, 18, 297–306. Available from: https://doi.org/10.1177/15563316211051295
An, J.S., Mabrouk, A., Khakha, R., Kley, K., Koga, H., Jacquet, C. et al. (2023) Assessment of return to sport and functional outcomes following distal femoral, double level and high tibial osteotomies for active patients with symptomatic varus malalignment. Knee Surgery, Sports Traumatology, Arthroscopy, 31(10), 4285–4291. Available from: https://doi.org/10.1007/s00167-023-07457-1
Bassi, J.S., Chan, J.P., Johnston, T. & Wang, D. (2022) Return to work and sport after distal femoral osteotomy: a systematic review. Sports Health: A Multidisciplinary Approach, 14, 681–686. Available from: https://doi.org/10.1177/19417381211041072
Cameron, J.I., McCauley, J.C., Kermanshahi, A.Y. & Bugbee, W.D. (2015) Lateral opening‐wedge distal femoral osteotomy: pain relief, functional improvement, and survivorship at 5 years. Clinical Orthopaedics & Related Research, 473, 2009–2015. Available from: https://doi.org/10.1007/s11999-014-4106-8
Chalmers, B.P., Limberg, A.K., Athey, A.G., Perry, K.I., Pagnano, M.W. & Abdel, M.P. (2019) Total knee arthroplasty after distal femoral osteotomy long‐term survivorship and clinical outcomes. The Bone & Joint Journal, 101–B, 660–666. Available from: https://doi.org/10.1302/0301-620X.101B6.BJJ-2018-1334.R2
Ciolli, G., Proietti, L., Mercurio, M., Corona, K., Maccauro, G., Schiavone Panni, A. et al. (2022) Return to sport following distal femur osteotomy: a systematic review. Orthopedic Reviews, 14, 337–374. Available from: https://doi.org/10.52965/001c.33774
Clement, N.D., Walker, L.C., Bardgett, M., Weir, D., Holland, J., Gerrand, C. et al. (2018) Patient age of less than 55 years is not an independent predictor of functional improvement or satisfaction after total knee arthroplasty. Archives of Orthopaedic and Trauma Surgery, 138, 1755–1763. Available from: https://doi.org/10.1007/s00402-018-3041-7
Dewilde, T.R., Dauw, J., Vandenneucker, H. & Bellemans, J. (2013) Opening wedge distal femoral varus osteotomy using the Puddu plate and calcium phosphate bone cement. Knee Surgery, Sports Traumatology, Arthroscopy, 21, 249–254. Available from: https://doi.org/10.1007/s00167-012-2156-6
Drexler, M., Gross, A., Dwyer, T., Safir, O., Backstein, D., Chaudhry, H. et al. (2015) Distal femoral varus osteotomy combined with tibial plateau fresh osteochondral allograft for post‐traumatic osteoarthritis of the knee. Knee Surgery, Sports Traumatology, Arthroscopy, 23, 1317–1323. Available from: https://doi.org/10.1007/s00167-013-2828-x
Duethman, N.C., Bernard, C.D., Camp, C.L., Krych, A.J. & Stuart, M.J. (2019) Medial closing wedge distal femoral osteotomy. Clinics in Sports Medicine, 38, 361–373. Available from: https://doi.org/10.1016/j.csm.2019.02.005
Ekeland, A., Nerhus, T.K., Dimmen, S. & Heir, S. (2016) Good functional results of distal femoral opening‐wedge osteotomy of knees with lateral osteoarthritis. Knee Surgery, Sports Traumatology, Arthroscopy, 24, 1702–1709. Available from: https://doi.org/10.1007/s00167-016-3988-2
Gaillard, R., Lording, T., Lustig, S., Servien, E. & Neyret, P. (2017) Total knee arthroplasty after varus distal femoral osteotomy vs native knee: similar results in a case control study. Knee Surgery, Sports Traumatology, Arthroscopy, 25, 3522–3529. Available from: https://doi.org/10.1007/s00167-017-4487-9
Gao, L., Madry, H., Chugaev, D.V., Denti, M., Frolov, A., Burtsev, M. et al. (2019) Advances in modern osteotomies around the knee: report on the Association of Sports Traumatology, Arthroscopy, Orthopaedic surgery, Rehabilitation (ASTAOR) Moscow International Osteotomy Congress 2017. Journal of Experimental Orthopaedics, 6, 9. Available from: https://doi.org/10.1186/s40634-019-0177-5
Hoorntje, A., van Ginneken, B.T., Kuijer, P.P.F.M., Koenraadt, K.L.M., van Geenen, R.C.I., Kerkhoffs, G.M.M.J. et al. (2019) Eight respectively nine out of ten patients return to sport and work after distal femoral osteotomy. Knee Surgery, Sports Traumatology, Arthroscopy, 27, 2345–2353. Available from: https://doi.org/10.1007/s00167-018-5206-x
Kandhari, V., Angadi, D., Myat, D., Fritsch, B., Parker, D. & Coolican, M. (2022) Long term outcomes of computer‐navigated lateral opening wedge distal femoral osteotomy for lateral compartment knee arthrosis. Revista Brasileira de Ortopedia, 57, 96–102. Available from: https://doi.org/10.1055/s-0040-1716765
Karas, V., Calkins, T.E., Bryan, A.J., Culvern, C., Nam, D., Berger, R.A. et al. (2019) Total knee arthroplasty in patients less than 50 years of age: results at a mean of 13 years. The Journal of Arthroplasty, 34, 2392–2397. Available from: https://doi.org/10.1016/j.arth.2019.05.018
Kellgren, J.H. & Lawrence, J.S. (1957) Radiological assessment of osteo‐arthrosis. Annals of the Rheumatic Diseases, 16, 494–502. Available from: https://doi.org/10.1136/ard.16.4.494
Kolb, A., Isak, V., Hobusch, G.M., Chiari, C. & Windhager, R. (2019) Distal femoral varus osteotomy: results of the lateral open‐wedge technique without bone grafting. International Orthopaedics, 43, 2315–2322. Available from: https://doi.org/10.1007/s00264-018-4216-0
Kosashvili, Y., Gross, A.E., Zywiel, M.G., Safir, O., Lakstein, D. & Backstein, D. (2011) Total knee arthroplasty after failed distal femoral varus osteotomy using selectively stemmed posterior stabilized components. The Journal of Arthroplasty, 26, 738–743. Available from: https://doi.org/10.1016/j.arth.2010.06.008
Kraeutler, M.J., McCulloch, P.C., Sherman, S.L. & Vidal, A.F. (2023) The principles of knee joint preservation: operative treatment strategies. Journal of Bone and Joint Surgery, 105, 1638–1646. Available from: https://doi.org/10.2106/JBJS.23.00212
Kucirek, N.K., Anigwe, C., Zhang, A.L., Ma, C.B., Feeley, B.T. & Lansdown, D.A. (2022) Complications after high tibial osteotomy and distal femoral osteotomy are associated with increasing medical comorbidities and tobacco use. Knee Surgery, Sports Traumatology, Arthroscopy, 30(12), 4029–4045. Available from: https://doi.org/10.1007/s00167-022-06865-z
Lobenhoffer, P., Kley, K., Freiling, D. & van Heerwaarden, R. (2017) Distale Femurosteotomie in schließender biplanarer Technik mit Stabilisierung durch spezifischen Plattenfixateur. Operative Orthopädie und Traumatologie, 29, 306–319. Available from: https://doi.org/10.1007/s00064-017-0493-9
Luceri, F., Tamini, J., Ferrua, P., Ricci, D., Batailler, C., Lustig, S. et al. (2020) Total knee arthroplasty after distal femoral osteotomy: a systematic review and current concepts. SICOT‐J, 6, 35. Available from: https://doi.org/10.1051/sicotj/2020033
Mayfield, C.K., Bolia, I.K., Mayer, E.N., Heidari, K.S., Heckmann, N., Pannell, W.C. et al. (2020) Factors associated with distal femoral osteotomy survivorship: data from the California Office of Statewide Health Planning and Development (OSHPD) Registry. Orthopaedic Journal of Sports Medicine, 8, 232596712095155. Available from: https://doi.org/10.1177/2325967120951554
Meisterhans, M., Flury, A., Zindel, C., Zimmermann, S.M., Vlachopoulos, L., Snedeker, J.G. et al. (2023) Finite element analysis of medial closing and lateral opening wedge osteotomies of the distal femur in relation to hinge fractures. Journal of Experimental Orthopaedics, 10, 33. Available from: https://doi.org/10.1186/s40634-023-00597-w
Odland, A.N., Callaghan, J.J., Liu, S.S. & Wells, C.W. (2011) Wear and lysis is the problem in modular TKA in the young OA patient at 10 years. Clinical Orthopaedics & Related Research, 469, 41–47. Available from: https://doi.org/10.1007/s11999-010-1429-y
Paley, D. & Tetsworth, K. (1992) Mechanical axis deviation of the lower limbs. Preoperative planning of multiapical frontal plane angular and bowing deformities of the femur and tibia. Clinical Orthopaedics and Related Research, 280, 65–71.
Peez, C., Grosse‐Allermann, A., Deichsel, A., Raschke, M.J., Glasbrenner, J., Briese, T. et al. (2023) Additional plate fixation of hinge fractures after varisation distal femoral osteotomies provides favorable torsional stability: a biomechanical study. The American Journal of Sports Medicine, 51, 3732–3741. Available from: https://doi.org/10.1177/03635465231206947
Quirno, M., Campbell, K.A., Singh, B., Hasan, S., Jazrawi, L., Kummer, F. et al. (2017) Distal femoral varus osteotomy for unloading valgus knee malalignment: a biomechanical analysis. Knee Surgery, Sports Traumatology, Arthroscopy, 25, 863–868. Available from: https://doi.org/10.1007/s00167-015-3602-z
Rupp, M.C., Themessl, A., Merkle, M., Insam, D., Hinz, M., Breulmann, F.L. et al. (2023) Favorable rates of return to activity and work following lateral closing wedge distal femoral osteotomy for femoral‐based symptomatic varus malalignment: an analysis at a mean 6‐year follow‐up. Knee Surgery, Sports Traumatology, Arthroscopy, 31(8), 3151–3159. Available from: https://doi.org/10.1007/s00167-022-07303-w
Schröter, S., Freude, T., Kopp, M.M., Konstantinidis, L., Döbele, S., Stöckle, U. et al. (2015) Smoking and unstable hinge fractures cause delayed gap filling irrespective of early weight bearing after open wedge osteotomy. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 31, 254–265. Available from: https://doi.org/10.1016/j.arthro.2014.08.028
Schröter, S., Konrads, C., Maiotti, M., Mederake, M., Fischer, C., Ahrend, M. et al. (2023) In closed wedge distal femur osteotomies for correction of valgus malalignment overcorrection of mLDFA should be avoided. Knee Surgery, Sports Traumatology, Arthroscopy, 31(9), 3992–3999. Available from: https://doi.org/10.1007/s00167-023-07449-1
van der Woude, J.A.D., Spruijt, S., van Ginneken, B.T.J. & van Heerwaarden, R.J. (2016) Distal femoral valgus osteotomy: bone healing time in single plane and biplanar technique. Strategies in Trauma and Limb Reconstruction, 11, 177–186. Available from: https://doi.org/10.1007/s11751-016-0266-2
Voleti, P.B., Wu, I.T., Degen, R.M., Tetreault, D.M., Krych, A.J. & Williams, 3rd, R.J. (2019) Successful return to sport following distal femoral varus osteotomy. Cartilage, 10, 19–25. Available from: https://doi.org/10.1177/1947603517743545
Walker‐Santiago, R., Tegethoff, J.D., Ralston, W.M. & Keeney, J.A. (2021) Revision total knee arthroplasty in young patients: higher early reoperation and rerevision. The Journal of Arthroplasty, 36, 653–656. Available from: https://doi.org/10.1016/j.arth.2020.08.052
Winkler, P.W., Rupp, M.C., Lutz, P.M., Geyer, S., Forkel, P., Imhoff, A.B. et al. (2021) A hinge position distal to the adductor tubercle minimizes the risk of hinge fractures in lateral open wedge distal femoral osteotomy. Knee Surgery, Sports Traumatology, Arthroscopy, 29, 3382–3391. Available from: https://doi.org/10.1007/s00167-020-06244-6
Wylie, J.D., Jones, D.L., Hartley, M.K., Kapron, A.L., Krych, A.J., Aoki, S.K. et al. (2016) Distal femoral osteotomy for the valgus knee: medial closing wedge versus lateral opening wedge: a systematic review. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 32, 2141–2147. Available from: https://doi.org/10.1016/j.arthro.2016.04.010
Wylie, J.D., Scheiderer, B., Obopilwe, E., Baldino, J.B., Pavano, C., Macken, C.J. et al. (2018) The effect of lateral opening wedge distal femoral varus osteotomy on tibiofemoral contact mechanics through knee flexion. The American Journal of Sports Medicine, 46, 3237–3244. Available from: https://doi.org/10.1177/0363546518799353
Yıldırım, C., Demirel, M., Ekinci, M., Öztürk, S. & Bozdağ, S.E. (2024) Biomechanical comparison of uniplanar versus biplanar lateral opening‐wedge distal femoral osteotomy techniques in terms of risk for medial hinge fracture. The Journal of Knee Surgery, 37, 623–630. Available from: https://doi.org/10.1055/a-2232-4971