title: [Supracondylar femur osteotomies around the knee. Patient selection, planning, operative techniques, stability of fixation, and bone healing].
abstract: BACKGROUND
  Similar to the reappreciation of high tibial osteotomy (HTO), supracondylar distal femur varus osteotomy (SCO) for lateral compartment osteoarthritis (OA) of the knee has gained renewed interest as new knowledge has become available on the influence of malalignment on the development, progression and symptoms of OA. Furthermore, the less than optimal results of total knee replacement (TKR) in younger patients have also led to renewed interest in joint-preserving treatment options.
  
  
  OBJECTIVE
  Varus SCO has not had the same success or widespread use as valgus HTO. The goal in SCO is similar to HTO, to shift the load from the diseased to the healthy ompartment, in order to reduce pain, improve function and delay placement of a TKR. Valgus OA however occurs much less frequently than varus OA and varus SCO is considered a technically more demanding procedure. In the past the surgical techniques for SCO were mainly dependent on difficult-to-use implants making the procedure more complex. Complication rates related to the failure of fixation up to 16 % have been reported.
  
  
  CONCLUSIONS
  The new biplane osteotomy technique fixated with a locking compression plate is very stable; bone healing potential is optimal using this technique and takes 6-8 weeks. Full weight bearing before full bone healing is possible without loss of correction.
  
  
  CONCLUSIONS
  In this article patient selection, planning, surgical techniques, stability of fixation and bone healing for SCO are discussed. In the past the surgical techniques for SCO were mainly dependent on difficult to use implants making the procedure more complex. Complication rates related to the failure of fixation of up to 16 % have been reported.
authors.affiliation: Department of Orthopaedics, Limb Deformity Reconstruction Unit, Sint Maartenskliniek Woerden, Polanerbaan 2, 3447GN, Woerden, Die Niederlande.
authors.forename: J-M
authors.initials: JM
authors.lastname: Brinkman
authors.forename: D
authors.initials: D
authors.lastname: Freiling
authors.forename: P
authors.initials: P
authors.lastname: Lobenhoffer
authors.forename: A E
authors.initials: AE
authors.lastname: Staubli
authors.forename: R J
authors.initials: RJ
authors.lastname: van Heerwaarden
mesh_terms: D003131:Combined Modality Therapy / Q000295:instrumentation / Q000379:methods; D005269:Femur / Q000601:surgery*; D006801:Humans; D016268:Internal Fixators; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D020370:Osteoarthritis, Knee / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D018579:Patient Selection; D011300:Preoperative Care / Q000379:methods; D011859:Radiography; D020127:Recovery of Function; D016896:Treatment Outcome; D014945:Wound Healing