Distal Femoral Medial Opening Wedge Osteotomy for Post-Traumatic, Distal Femoral Varus Deformity

다국어 초록 (Multilingual Abstract)

Restoration of neutral mechanical alignment of the lower limb is an important factor in the treatment of unicompartmental arthrosis. Traditionally, medial opening wedge high tibial osteotomy has been widely performed to correct varus malalignment with unicompartmental arthrosis. However, an ideal indication for the high tibial osteotomy is the knee with metaphyseal tibial varus malalignment. The basic principle of corrective osteotomy is performing an osteotomy at the center of the deformity to prevent abnormal joint line obliquity. If pathologic distal femoral varus deformity is the cause of genu varum, the osteotomy should be performed in the distal femur. Reports of medial opening wedge distal femoral osteotomy (DFO) to correct varus malalignment are rare. We present a case of this very rare and challenging condition in a 47­year­old male, which was successfully treated by medial opening wedge DFO.

참고문헌 (Reference)

1 Gugenheim JJ, "The effects of femoral shaft malrotation on lower extremity anatomy" 18 : 658-664, 2004

2 Schuster P, "Tenyear results of medial open-wedge high tibial osteotomy and chondral resurfacing in severe medial osteoarthritis and varus malalignment" 46 : 1362-1370, 2018

3 Dugdale TW, "Preoperative planning for high tibial osteotomy. The effect of lateral tibiofemoral separation and tibiofemoral length" (274) : 248-264, 1992

4 Brinkman JM, "Osteotomies around the knee : patient selection, stability of fixation and bone healing in high tibial osteotomies" 90 : 1548-1557, 2008

5 Gardiner A, "Osteotomies about the knee for tibiofemoral malalignment in the athletic patient" 38 : 1038-1047, 2010

6 Dettoni F, "High tibial osteotomy versus unicompartmental knee arthroplasty for medial compartment arthrosis of the knee : a review of the literature" 30 : 131-140, 2010

7 McNamara I, "High tibial osteotomy : evolution of research and clinical applications : a Canadian experience" 21 : 23-31, 2013

8 Young Chan Kim, "Distal Femoral Varus Osteotomy for Valgus Arthritis of the Knees: Systematic Review of Open versus Closed Wedge Osteotomy" 대한슬관절학회 30 (30): 3-16, 2018

9 Feucht MJ, "Degree of axis correction in valgus high tibial osteotomy : proposal of an individualised approach" 38 : 2273-2280, 2014

10 Kijowski R, "Comparison of 1.5- and 3.0-T MR imaging for evaluating the articular cartilage of the knee joint" 250 : 839-848, 2009