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French surgeons recommend double level osteotomies for severe genu varum deformity

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BERLIN — Although rarely performed, double level osteotomies to correct severe genu varum deformity in 42 patients were associated with no complications, but an investigator on the team studying the mid-term outcomes reported one medial side recurrence of the deformity associated with a knee infection that developed during the follow-up period.

The team used preoperative navigation and radiographs to determine the amount of correction that the osteotomies — one on the femur and one on the tibia — needed to provide, Dominique Saragaglia, MD, said at the 13th EFORT Congress 2012, here.

By adding navigation to a surgery he did for years without computer assistance, Saragaglia contends the procedure became considerably easier to perform.

“Navigation can improve the accuracy of the correction compared with non-computer assisted osteotomy,” he said.

“Following double level osteotomy, the satisfaction of the patient is very high. Despite the difficulty of the procedure, complications are very rare. We recommend double level osteotomy for severe genu varum deformity,” Saragaglia said.

Thirty-six patients were either satisfied or very satisfied with their osteotomies, he noted. In terms of postoperative function, the patients’ mean Lysholm-Tegner score was 83.3 points. The mean Knee Osteoarthritis Outcome Score was 95.1 points.

Excluding the patient who had a loss of correction, “The goals were reached in 39 cases at 97%, and 36 cases had a tibial mechanical axis at 90º +/- 2º and we had only one case of 93º. The mean hip knee angle was 181º.”

 The session moderators congratulated Saragaglia and colleagues on their low complication rate.

Reference:

• Saragaglia D, Blaysat M, Mercier N, Grimaldi M. Results of 42 computer-assisted double level osteotomies for severe genu varum deformity: a 1 to 9 years followup. Paper #12-2151.  Presented at the 13th EFORT Congress 2012. May 23-25. Berlin.
• Disclosures: Saragaglia has no relevant financial disclosures.