Single Cut Distal Femoral Varus Osteotomy (SCFO): A Preliminary Study | ||
| The Archives of Bone and Joint Surgery | ||
| مقاله 9، دوره 5، شماره 5، آذر 2017، صفحه 322-327 اصل مقاله (1.12 M) | ||
| نوع مقاله: RESEARCH PAPER | ||
| شناسه دیجیتال (DOI): 10.22038/abjs.2017.23007.1610 | ||
| نویسندگان | ||
| Reza Abdi1؛ Ramin Hajzargarbashi* 2؛ Mohammad H. Ebrahimzadeh3 | ||
| 1Birjand University of Medical Sciences, Birjand, Iran | ||
| 2Pediatrics Center of Excellence, Tehran University of Medical Sciences,Tehran, Iran. | ||
| 3Orthopedic Research Center Department of Orthopedic Surgery, Qhaem Hospital, Mashad University of Medical Sciences, Mashad, Iran | ||
| چکیده | ||
| Background: Genu valgum usually originates from a deformity of distal femur that is often corrected by distal femoral varus osteotomy. The osteotomy includes both components of angulationcorrection and translation because the site of osteotomy is not commonly at the apex of deformity. Improvement of patellar tracking not only depends on valgus correction, but also it may be partially due to centralization of the trochlear groove under the femoral anatomical axis (FAA). We asked whether we could accurately correct the deformities based on our preoperative goals for the correction of the mechanical axis and centralization of the trochlear groove under the FAA by using a single bone cut. This study describes a new lateral single cut distal femoral osteotomy (SCFO) that enables concurrent correction of angulation and translation. Methods: This study was done on 12 young adult patients with femoral juxta-articular genu valgum deformity using SCFO. The average age at operation was 21 years (range: 16-25). SCFO is a type of closing-opening distal femoral osteotomy that corrects the valgus deformity of the distal femur while the translation of the distal fragment is done using one oblique cut. It centralizes the trochlear groove under the FAA. We compared the pre and postoperative radiographic and clinical variables including mechanical tibiofemoral angle, knee range of motion (ROM), International knee documentation committee (IKDC) score and the time to union. Mean follow-up of the patients was 24 months. Results: The average mechanical tibiofemoral angle improved from 16 degrees (10-23) to 1 degrees (-2 to +2). IKDC subjective score slightly improved from preoperative (65) to 2-year follow-up (71). Centralization of the trochlea was achieved in all patients. Conclusion: SCFO can be a reasonable alternative for correction of the distal femur genu valgum deformity. It can centralize the patellar groove under the FAA with satisfactory clinical outcomes. | ||
| کلیدواژهها | ||
| Femoral osteotomy؛ Genu valgum؛ SCFO؛ Single cut؛ Valgus | ||
| مراجع | ||
|
1. Saithna A, Kundra R, Modi CS, Getgood A, Spalding T. Distal femoral varus osteotomy for lateral compartment osteoarthritis in the valgus knee. A systematic review of the literature. Open Orthop J. 2012; 6(2):313-9. 2. Omidi-Kashani F, Hasankhani IG, Mazlumi M, Ebrahimzadeh MH. Varus distal femoral osteotomy in young adults with valgus knee. J Orthop Surg Res. 2009; (4):15. 3. Paccola CA. Pre-operative planning and surgical technique of the open wedge supracondylar osteotomy for correction of valgus knee and fixation with a fixedangle implant. Rev Bras Ortop . 2015; 45(6):627-35. 4. Gupta V, Kamra G, Singh D, Pandey K, Arora S. Wedgeless ‘V’ shaped distal femoral osteotomy with internal fixation for genu valgum in adolescents and young adults. Acta Orthop Belg. 2014; 80(2):234-40. 5. Luna-Pizarro D, Moreno-Delgado F, De la Fuente- Zuno JC, Meraz-Lares G. Distal femoral dome varus osteotomy: surgical technique with minimal dissection and external fixation. Knee. 2012; 19(2):99-102. 6. Puddu G, Cipolla M, Cerullo G, Franco V, Gianni E. Which osteotomy for a valgus knee? Int Orthop. 2010; 34(2):239-47. 7. Dhar SA, Butt MF, Mir MR, Dar TA, Sultan A. A reciprocating ledge technique in closing wedge osteotomy for genu valgum in adolescents. J Orthop Surg (Hong Kong) . 2009; 17(3):313-6. 8. Paley D, Tetsworth K. Mechanical axis deviation of the lower limbs: preoperative planning of uniapical angular deformities of the tibia or femur. Clinical orthopaedics and related research. 1992; (280):48-64. 9. Mathews J, Cobb AG, Richardson S, Bentley G. Distal femoral osteotomy for lateral compartment osteoarthritis of the knee. Orthopedics. 1998; 21(4):437-40. 10. Marti RK, Schroder J, Witteveen A . The closed wedge varus supracondylar osteotomy. Oper Tech Sports Med . 2000; 8(1):48-55. 11. Grelsamer RP. Distal femoral varus osteotomy for osteoarthritis of the knee. J Bone Joint Surg Am. 2005; 87(8):1886. 12. Puddu G, Cipolla M, Cerullo G, Franco V, Gianni E. Osteotomies: the surgical treatment of the valgus knee. Sports Med Arthrosc. 2007; 15(1):15-22. 13. Dugdale TW, Noyes FR, Styer D. Preoperative Planning for High Tibial Osteotomy: The Effect of Lateral Tibiofemoral Separation and Tibiofemoral Length. Clin Orthop Relat Res. 1992; 274:248-64. 14. Stevens PM, Maguire M, Dales MD, Robins AJ. Physeal stapling for idiopathic genu valgum. J Pediatr Orthop . 1999; 19(5):645-9 15. Brinkman JM. Fixation stability and new surgical concepts of osteotomies around the knee.[ Doctoral dissertation]. Utrecht: Utrecht University; 2013. 16. Hinterwimmer S, Minzlaff P, Saier T, Niemeyer P, Imhoff AB, Feucht MJ. Biplanar supracondylar femoral derotation osteotomy for patellofemoral malalignment: the anterior closed-wedge technique. Knee Surg Sports Traumatol Arthrosc. 2014; 22(10):2518-21. 17. Andrade MAPd, Gomes DC, Portugal AL, Silva GM. Osteotomia femoral distal de varização para osteoartrose no joelho valgo: seguimento em longo prazo. Rev Bras Ortop. 2009; 44(4):346-50. 18. Postel M, Langlais F. Osteotomies du genou pour gonarthrose. Encyclopédie médico-chirurgicale: techniques chirurgicales, orthopédie Paris: Editions Techniques; 1977. P. 1-17. 19. Thein R, Bronak S, Thein R, Haviv B. Distal femoral osteotomy for valgus arthritic knees. J Orthop Sci. 2012; 17(6):745-9. 20. Gugenheim JJ Jr., Brinker MR. Bone realignment with use of temporary external fixation for distal femoral valgus and varus deformities. J Bone Joint Surg Am. 2003; 85-A(7):1229-37. 21. Seah KT, Shafi R, Fragomen AT, Rozbruch SR. Distal femoral osteotomy: is internal fixation better than external? Clin Orthop Relat Res. 2011; 469(7):2003-11. 22. Omidi-Kashani F, Hasankhani IG, Mazlumi M, Ebrahimzadeh MH. Varus distal femoral osteotomy in young adults with valgus knee. J Orthop Surg Res. 2009; 13: 4:15. 23. Cameron JI, McCauley JC, Kermanshahi AY, Bugbee WD. Lateral Opening-wedge Distal Femoral Osteotomy: Pain Relief, Functional Improvement, and Survivorship at 5 Years. Clin Orthop Relat Res. 2015; 473(6):2009-15. 24. Chahla J, Mitchell JJ, Liechti DJ, Moatshe G, Menge TJ, Dean CS, LaPrade RF. Opening- and Closing-Wedge Distal Femoral Osteotomy: A Systematic Review of Outcomes for Isolated Lateral Compartment Osteoarthritis. Orthop J Sports Med. 2016; 6:4(6):2325967116649901. | ||
|
آمار تعداد مشاهده مقاله: 941 تعداد دریافت فایل اصل مقاله: 1,254 |
||
