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The effect of lateral opening wedge distal femoral osteotomy on leg length

113

The

Knee Society Score

(KSS) functional

component improved from 50.4 (26.0-80.0) to

68.5 (1.0-97.0), though this did not reach

statistical significance (p=0.12). 25 patients

were satisfied or very satisfied, and 4 were

unsatisfied. There was one loss of fixation

(fig. 3), two delayed or non-unions and one

case of post-operative stiffness. There were

five revisions to arthroplasty for disease

progression at mean time of 166.6 months post-

operatively. The probability of survival at

60 months was 91.4% [95% confidence interval

100%-74.9%] with end-point of revision to

total knee arthroplasty and 87.6% [95%

confidence interval 100%-74.1%] for revision

for complications (fig. 4).

Fig. 2: Postoperative radiographs of a 50 year old patient who

presented with an idiopathic genu valgum of 188°.

Fig. 3: 40 year old patient with multiple

sclerosis with loss of fixation of the osteotomy

at day 20 postoperatively: Preoperative long

leg views with mFTA of 197°, immediate

postoperative radiograph, fracture at day 20.

The medial hinge fractured secondary to poor

bone quality.