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General Orthopaedics

DISTAL FEMORAL VARUS OSTEOTOMY: CLINICAL AND RADIOGRAPHIC EVALUATION OF 91 PATIENTS IN THE MEDIUM AND LONG TERM

The International Society for Technology in Arthroplasty (ISTA), 27th Annual Congress. PART 1.



Abstract

PURPOSE

Lateral osteoarthritis of the valgus knee is a challenging problem, especially for young and active patients, where prosthetic replacement is not indicated. The purpose of the present study is to evaluate clinically and radiographically 91 patients with valgus knee treated with distal femoral varus osteotomy in mid and long term follow-up.

METHODS

A clinical retrospective evaluation based on IKDC, OXFORD and WOMAC scores of 91 patients at 4 to 10 years of follow-up was performed. Subjective evaluation was based on a VAS for pain self-assessment. Radiographic evaluation was performed by an independent observer of all 91 patients at 2 to 6 years of follow-up. A survival analysis was performed assuming revision for any reason as primary endpoint.

RESULTS

The present study reported a marked improvement in clinical score at a mean 8,3 years of follow-up with statistical significance (p<0.005). The radiographic evaluation revealed a reduction of 7,0° and 4,2° of FTA and HKA angles respectively (p<0.05) at a mean follow up of 4,3 years, while small differences were observed with TPA and PTS angles. The 8-years treatment survivorship was 95,6%.

CONCLUSIONS

The present study demonstrates that distal femoral varus osteotomy is an effective and reliable option to manage lateral tibio-femoral compartment early degenerative joint disease in young- to middle-age patients, providing a satisfactory clinical improvement at a mean follow-up of 8 years. Furthermore, its survivorship at 8-years follow-up is over 95%.


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