title: Distal femoral osteotomy for valgus arthritic knees.
abstract: BACKGROUND
  Patients with genu valgum and isolated osteoarthritis of the lateral compartment are candidates for distal femoral varus osteotomy. Opening wedge osteotomy is a precise method to realign the knee axis with good short to midterm results. The aim of this study was to evaluate the outcome of patients who have had opening wedge distal femoral varus osteotomy utilizing the Puddu plate (Arthrex, Naples, FL, USA) fixation.
  
  
  METHODS
  The study included 6 patients (7 knees) followed for an average of 6.5 ± 1.5 years after distal femoral varus osteotomy with Puddu fixation and iliac crest allograft. Clinical outcome was assessed by the Oxford Knee Score and subjective satisfaction rating. Pre- and postoperative radiographs were evaluated for tibiofemoral angle, Insall-Salvati index and Kellgren-Lawrence Grading Scale for osteoarthritis.
  
  
  RESULTS
  The mean age at surgery was 46.7 ± 10.7 years. The mean body mass index at surgery was 29.6 ± 5.6 kg/m(2). Overall at the last follow-up the mean Oxford Knee Score improved from 13.1 ± 8.6 to 26 ± 12.5. The average subjective satisfaction rate at the last follow-up was 6.6 ± 2.8. The measured tibiofemoral angle was corrected by an average of 11.9°. There was no worsening of arthritic changes in comparison to the preoperational radiographs. All radiographs showed full incorporation of the bone grafts, and there were no hardware failures. At the end of this study none of the patients required additional surgery, and none had knee replacement.
  
  
  CONCLUSIONS
  Opening wedge distal femoral varus osteotomy with Puddu plate fixation can be a reliable procedure for the treatment of lateral compartment osteoarthritis of the knee associated with valgus deformity.
authors.affiliation: Arthroscopy and Sports Injuries Unit, Hasharon Hospital, Rabin Medical Center, 7 Keren Kayemet St, 49372 Petach-Tikva, Israel.
authors.forename: Rafael
authors.initials: R
authors.lastname: Thein
authors.forename: Shlomo
authors.initials: S
authors.lastname: Bronak
authors.forename: Ran
authors.initials: R
authors.lastname: Thein
authors.forename: Barak
authors.initials: B
authors.lastname: Haviv
mesh_terms: D000328:Adult; D001860:Bone Plates; D016025:Bone Transplantation; D015331:Cohort Studies; D005260:Female; D005269:Femur / Q000601:surgery*; D056304:Genu Valgum / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications / Q000601:surgery*; D010027:Osteotomy; D016896:Treatment Outcome