Study: Distal femoral osteotomy offers acceptable option to treat knee OA, postpone TKA

SEATTLE — Distal femoral osteotomy can be a good surgical option to treat young patients with severe unicompartmental knee osteoarthritis and malalignment, according to research presented at the American Orthopaedic Society for Sports Medicine Annual Meeting.

“Distal femoral osteotomy is a good option for young, active patients with symptomatic lateral chondrosis and valgus malalignment. It provides durable, functional improvement with low rates of serious complications,” said Andreas H. Gomoll, MD, here.

Gomoll and colleagues conducted a retrospective review of 78 open-wedge distal femoral osteotomies in 71 patients at a single institution from 2001 to 2011. Average age was 33 years and average body mass index was 28. Patients were followed for an average of 43 months. Overall, 60.3% of procedures were combined with cartilage repairs and subsequent procedures performed after the initial osteotomy were based on complications.

Gomoll said seven patients eventually underwent total knee arthroplasty. Complications most frequently observed were hardware pain (20.5%) and arthrofibrosis (12.8%). Other complications included hardware failure (3.8%), septic arthritis (3.8%) and nonunion (2.6%). Hardware removal occurred in 14 patients and two patients need revision. All patients with arthrofibrosis had intra-articular surgical manipulation for cartilage repair or other associated procedures.

The estimated mean survival time was 123 months while a survival probability of 78% was determined at 10-year follow-up. —by Christian Ingram

Reference:

Ramanathan D. Paper #29. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 10-13, 2014; Seattle.

Disclosure: Gomoll is a paid consultant for Aesculap/B.Braun, Cartiheal, Geistlich, Genzyme, Norvartis, and SBM. He also received royalties from SLACK Incorporated and is a board member for Cartilage, Orthopaedic Journal of Sports Medicine, AOSSM and ICRS.