Functional and Radiographic Results of Arthroscopy-Assisted Lateral Open-Wedge Distal Femur Osteotomy for Lateral Compartment Osteoarthritis with Valgus Knee

Abstract

Treating lower extremity malalignment-related knee osteoarthritis, especially valgus alignment, is a challenge. A high revision rate was observed with patients who underwent unicompartmental knee arthroplasty, so distal femur osteotomy has regained its popularity. This research aimed to evaluate the radiographic and functional outcomes of arthroscopy-assisted lateral open-wedge distal femur osteotomy (LOWDFO) for patients with lateral compartment osteoarthritis and valgus knees with a minimum follow-up of 2 years. Our study retrospectively included isolated lateral osteoarthritis (Outerbridge grade 3 and grade 4) of the knee related to valgus alignment and a young age (<65 y/o) with the demand for a high-impact activity event. Preoperative and postoperative radiographic and functional outcomes were evaluated. Significant pre-operative and postoperative mechanical correction was observed with mechanical axis deviation (preop/postop: −28.77 ± 12.98/−9.45 ± 7.36, p < 0.001), hip-knee angle (preop/postop: 7.64 ± 3.62/2.68 ± 2.04, p < 0.001), and mechanical lateral distal femoral angle (mLDFA, preop/postop: 10.9 ± 4.14/5.66 ± 3.71, p < 0.001). The International Knee Documentation Committee (IKDC) score also showed improvement after the operation (preop/postop: 57.36 ± 11.98/79.02 ± 4.58, p = 0.002). In conclusion, lateral open-wedge distal femur osteotomy is effective in treating patients with lateral compartment osteoarthritis and valgus knees with a low complication rate and excellent outcome.