Medial Closing-Wedge Distal Femoral Osteotomy

Flashcards about medial closing-wedge distal femoral osteotomy

Distal femoral varus osteotomy

A surgical procedure to correct limb alignment and decrease the progression of pathology in lateral compartment cartilage lesions and degenerative disease.

Surgical techniques for distal femoral varus osteotomy

Lateral opening-wedge and medial closing-wedge correction.

Indications for medial closing-wedge distal femoral osteotomy

Cartilage lesions, localized degenerative disease, femorotibial lateral compartment osteoarthritis, intact medial compartment cartilage and medial meniscus, age less than 60, desire to stay active.

Absolute contraindications for distal femoral osteotomy

Tricompartmental osteoarthritis, patellofemoral pain, osteoarthritis or meniscal deficiency in the compartment intended for weight bearing.

Relative contraindications for distal femoral osteotomy

Smoking and knee range of motion less than 90 degrees.

Type of implant used in the described surgical technique

Anterolateral tibial plateau locking plate.

Description of the Chevron-type osteotomy

The anterior arm having twice the length of the posterior arm.

Screw placement consideration

The most posterior hole in the distal part of the locking plate remains without a screw so as not to violate the intercondylar notch.

Possible complications of medial closing-wedge distal femoral osteotomy

Neurovascular injury, nonunion, fracture of condyle, deep infection, failure to properly correct alignment, hematoma, compartment syndrome.

Aim of alignment when DFVO is combined with a cartilage repair procedure

Neutral alignment.