Distal femoral varus osteotomy for correction of valgus deformity

Abstract

Lower extremity malalignment in association with arthritis or cartilage deficiency is a common clinical entity. Identification and management of limb malalignment, either alone or in conjunction with cartilage restoration, is increasingly recognized as an essential part of the treatment algorithm. Although osteotomies around the knee have been described extensively in the literature, most studies report on the use of proximal tibial valgus osteotomy for varus deformities. The use of varus-producing osteotomies for valgus deformity is less common and few clinical studies have been published. These studies generally report the outcome of small cohorts of patients undergoing medial closing wedge osteotomies for treatment of lateral compartment arthritis and have documented acceptable outcomes at intermediate term follow-up [1-7]. The use of opening wedge osteotomies on the tibial side for varus deformity has become well established as a favored alternative and is now used more commonly than closing wedge techniques [8]. However, little is known regarding the analogous opening wedge technique for femoral osteotomy used to correct valgus deformity. Our experience with the opening wedge distal femoral varus osteotomy has been favorable and is an integral component of our management of patients with cartilage or meniscal pathology of the lateral compartment of the knee.