title: Femoral deformity planning: intentional placement of the apex of deformity.
abstract: Traditionally, correction of femoral deformity has been performed with osteotomies through the center of rotation of angulation (CORA), but the CORA location is not always practical. If the osteotomy is created at a site adjacent to the CORA, an additional translation must be performed to accurately correct the deformity. However, at times, the ideal osteotomy site may require an unfeasible amount of translation. Multiple osteotomies may also be problematic, and when overcorrection of the mechanical axis is planned, the CORA method is not practical.This article describes a novel method by which the surgeon may choose the location of the osteotomy regardless of the location of the CORA and may consolidate a multiapical deformity into a single corrective osteotomy. Furthermore, intentional mechanical axis overcorrection may be performed to unload knee joint arthritis. Simple, complex, and multiapical deformities may now be corrected via a single familiar surgical procedure, such as a distal femoral osteotomy, and the need for translation is eliminated.
authors.affiliation: Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA. fabricantp@hss.edu
authors.forename: Peter D
authors.initials: PD
authors.lastname: Fabricant
authors.forename: James M
authors.initials: JM
authors.lastname: Camara
authors.forename: S Robert
authors.initials: SR
authors.lastname: Rozbruch
mesh_terms: D000368:Aged; D003198:Computer Simulation; D005260:Female; D005269:Femur / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D010027:Osteotomy / Q000379:methods*; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome