CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2019; 54(02): 198-201
DOI: 10.1016/j.rbo.2017.10.007
Original Article | Artigo Original
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revnter Publicações Ltda Rio de Janeiro, Brazil

Closing-Wedge Distal Femoral Osteotomies—Retrospective Study[*]

Article in several languages: português | English
Pedro Barreira Cabral
1   Instituto Cohen São Paulo, São Paulo, SP, Brasil
,
Diego Costa Astur
2   Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
,
Eduardo Vasconcelos Freitas
1   Instituto Cohen São Paulo, São Paulo, SP, Brasil
,
Bruno Silveira Pavei
1   Instituto Cohen São Paulo, São Paulo, SP, Brasil
,
Camila Cohen Kaleka
1   Instituto Cohen São Paulo, São Paulo, SP, Brasil
,
Moises Cohen
2   Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
› Author Affiliations
Further Information

Publication History

24 July 2017

24 October 2017

Publication Date:
22 April 2019 (online)

Abstract

Objective To describe the surgical technique of distal closing-wedge femoral osteotomy and a cases series submitted to this technique.

Methods A total of 26 patients submitted to medial closing-wedge distal femoral osteotomy from 2002 to 2013 were evaluated. All of the patients had their medical files and imaging exams reviewed to evaluate the degree of correction and their current state.

Results Out of the 26 patients, 12 were male and 14 were female. Their mean age was 47.15 years old. In all of the cases, a neutral alignment related to the anatomical axis was achieved. Most of the patients presented bone healing at 6 weeks. There were no cases of bleeding during the surgery. One patient presented with delayed bone healing. One patient complained of plaque-related discomfort, requiring the removal of the device. One patient had a superficial infection, but no osteotomy revision was needed. There were no cases of deep venous thrombosis or of pulmonary thromboembolism. To date, there has been no conversion to total knee replacement.

Conclusion Treatment with medial closing-wedge distal femoral osteotomy sustained the proposed correction in patients with up to 15 years of follow-up.

* Work developed at the Centro de Traumatologia do Esporte, Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.


 
  • References

  • 1 Hussain SM, Neilly DW, Baliga S, Patil S, Meek R. Knee osteoarthritis: a review of management options. Scott Med J 2016; 61 (01) 7-16
  • 2 Brouwer RW, Raaij van TM, Bierma-Zeinstra SM, Verhagen AP, Jakma TS, Verhaar JA. Osteotomy for treating knee osteoarthritis. Cochrane Database Syst Rev 2007; (03) CD004019
  • 3 Haviv B, Bronak S, Thein R, Thein R. The results of corrective osteotomy for valgus arthritic knees. Knee Surg Sports Traumatol Arthrosc 2013; 21 (01) 49-56
  • 4 Chahla J, Mitchell JJ, Liechti DJ, Moatshe G, Menge TJ, Dean CS. , et al. Opening- and closing-wedge distal femoral osteotomy: a systematic review of outcomes for isolated lateral compartment osteoarthritis. Orthop J Sports Med 2016; 4 (06) 2325967116649901
  • 5 Hoorntje A, Witjes S, Kuijer PPFM, Koenraadt KLM, van Geenen RCI, Daams JG. , et al. High rates of return to sports activities and work after osteotomies around the knee: a systematic review and meta-analysis. Sports Med 2017; 47 (11) 2219-2244
  • 6 Leone JM, Hansse AD. Osteotomia ao redor do joelho: perspectiva americana. In: Scott NW, ed. Insall & Scott cirurgia do joelho. 5 a. ed. Rio de Janeiro: Elsevier; 2014: 2070-2105
  • 7 Murphy GA. Total ankle arthroplasty. In: Azar FM, Beaty JH, Canale ST. , eds. Campbell's operative orthopaedics. Philadelphia: Elsevier; 2017: 508-534
  • 8 Visser J, Brinkman JM, Bleys RL, Castelein RM, van Heerwaarden RJ. The safety and feasibility of a less invasive distal femur closing wedge osteotomy technique: a cadaveric dissection study of the medial aspect of the distal femur. Knee Surg Sports Traumatol Arthrosc 2013; 21 (01) 220-227
  • 9 Gardiner A, Richmond JC. Periarticular osteotomies for degenerative joint disease of the knee. Sports Med Arthrosc Rev 2013; 21 (01) 38-46
  • 10 Wylie JD, Jones DL, Hartley MK. , Kapron AL, Krych AJ, Aoki SK, et al. Distal femoral osteotomy for the valgus knee: medial closing wedge versus lateral opening wedge: a systematic review. Arthroscopy 2016; 32 (10) 2141-2147
  • 11 Lobenhoffer P, Kley K, Freiling D, van Heerwaarden R. [Medial closed wedge osteotomy of the distal femur in biplanar technique and a specific plate fixator]. Oper Orthop Traumatol 2017; 29 (04) 306-309
  • 12 Shantz JS, Marcucio R, Kim HT, Miclau T. Bone and cartilage healing. In: Court-Brown CM, Heckman JD, Mcqueen MM, Ricci WM, Tornetta P. , eds. Rockwood and Green's fractures in adults. Philadelphia: Wolters Kluwer; 2015: 109-125
  • 13 Forkel P, Achtnich A, Metzlaff S, Zantop T, Petersen W. Midterm results following medial closed wedge distal femoral osteotomy stabilized with a locking internal fixation device. Knee Surg Sports Traumatol Arthrosc 2015; 23 (07) 2061-2067