title: Modified Aglietti procedure (supracondylar femoral osteotomy) for correction of the post-rachitic valgus deformity of the knee in adolescents - A short case series.
abstract: BACKGROUND
  Supracondylar femoral osteotomy is the time tested method, used for correcting the angular (varus & valgus) deformities at the knee. Traditionally, Coventry type of femoral osteotomy is performed. Here, a medial or lateral based wedge of bone is removed or an open wedge osteotomy is made & subsequently the space is filled with the bone graft to achieve the desired correction. This osteotomy is subsequently stabilized with Kirschner wires or plate & screws. Later the limb is externally supported in brace or plaster cast till osteotomy unites. Here we present a case series of 10 cases, where we have analyzed the efficacy of Aglietti procedure for achieving normal limb alignment with good patient satisfaction and subsequent knee function as a method of femoral supracondylar osteotomy for correcting the valgus deformity at the knee. Short series results are also encouraging with regard to the operating time, per-operative blood loss, postoperative stability of osteotomy, early starting of postoperative rehabilitation due to good stability at osteotomy & subsequent functional outcome in relation to final range of motion (ROM) - flexion after 6 months of surgery.
  Ten valgus adolescent knees were operated in 7 patients by the Aglietti procedure for correcting the angular deformity at the knee. The results were analyzed taking into consideration the desired correction to achieve normal limb alignment, operating time, blood loss during surgery estimated by the number of surgical mops used, stability of the osteotomy in the postoperative period & ultimate range of motion (ROM) obtained at the end of 6 months after the surgery.
  
  
  RESULTS
  The age of the patients taken up in the study were in the range of 12-16 years. Females predominated (n = 5) against 2 males. The time taken for the procedure ranged from 40 to 50 min. The size of the surgical mops used was 15 × 20 cm. 1-2 surgical mops used per patient. The range of flexion achieved at the end of 6 months after surgery was from 125 to 135°.
  
  
  CONCLUSIONS
  In our case series we found Aglietti procedure as an effective and easy method to correct the valgus deformity in post-rachitic adolescent knees with good patient satisfaction and no complications. However, more number of cases or a randomized control study with comparison between various techniques including Coventry method and a long term follow may be needed to make a final conclusion of establishing the superiority of this procedure over other methods.
authors.affiliation: North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, Meghalaya 793018, India.
authors.forename: Sharat
authors.initials: S
authors.lastname: Agarwal
keywords: Aglietti procedure; Supracondylar femoral osteotomy; Valgus knee