Distal Femoral Osteotomy Plate

Usually we might want to obtain an MRI scan which is finished on a separate visit to the Radiology division. An MRI allows us to have a look at the menisci to see if they are torn and will require consideration on the time of surgical procedure. It also allows us to check that the cartilage within the medial compartment is in good condition and might stand up to some additional force passing by way of it. After your MRI scan we’ll convey you back to clinic to debate the results of the MRI and discuss therapy choices.

The intermuscular septum between vastus lateralis and biceps femoris, posterior aspect of vastus medialis is identified and elevated. Meticulous dissection within the right airplane is important here as this can determine the publicity throughout the procedure. Depiction of both the traditional mechanical and anatomic axis of the lower limb in a bilateral standing full-length anteroposterior radiograph. The mechanical axis follows a line from the femoral head through the center of the talus. The anatomic axis follows a line by way of the middle of the femoral shaft via the center of the tibia to the center of the ankle. A bony bridge on the lateral facet of the expansion plate was famous on MRI taken at age of 16.

Advantages Of Distal Femoral Osteotomy

Although not routine, if articular or meniscal pathology is suspected following preoperative evaluation, magnetic resonance imaging may be considered. Distal femoral osteotomy is performed to correct knee alignment which may result in extreme loading and degeneration of one facet of the knee joint. The procedure entails cutting of the distal femur, repositioning the bones and securing them in the proper alignment. In common, one must be between the ages of sixteen and a roughly higher age of fifty five to benefit from a distal femoral osteotomy. Distal femoral osteotomies are mostly carried out with chronic MCL tears or ACL tears. Patients who’ve a distal femoral osteotomy, which is mainly a surgical fracture, have to be on crutches until the osteotomy heals sufficiently to begin weightbearing.

Otherwise, there is a danger that the hinge on the inside part of the knee could crack or the screws could break as a result of an excessive amount of weight is being positioned on them from relying on the plate and screws to hold the fracture aside quite than permitting the bone to heal. The most typical type of distal femoral osteotomy is one that entails an incision on the outside of the knee. Distal femoral medial closing-wedge osteotomy on the right distal femur of a cadaveric specimen. The affected person is positioned within the supine position, with viewing from the left aspect of the patient.

Standardised Radiological And Clinical Assessment

Occasionally patients have damage to their articular cartilage that is limited to the skin of the knee. When this space alone is affected then it is named lateral compartment osteoarthritis. When the cartilage in all three compartments of the knee is damaged then this is named tricompartmental osteoarthritis and this isn’t usually suitable for osteotomy surgical procedure. If a concomitant intra-articular procedure, such as a lateral femoral condyle cartilage process is to be performed, then an prolonged lateral peripatellar approach is recommended. Typically, we choose to finish concomitant procedures previous to the osteotomy; arthroscopy may be used for diagnostic functions as needed before proceeding . In instances of concomitant procedures, for example, lateral femoral condyle osteochondral allograft transplantation is completed first to keep away from hyperflexing the knee that would cause intraoperative loss of fixation.

The success fee of distal femoral osteotomies is felt to be about 70% to 75% at 10 years. The success rate additionally depends upon the amount of arthritis of the lateral compartment, if there’s a concurrent meniscal transplant or cartilage resurfacing procedure, and in addition if the patient is not significantly overweight . In common, sufferers who smoke aren’t candidates for a distal femoral osteotomy as a result of bone doesn’t heal very nicely in smokers and this is able to typically be a contraindicated surgical process on this circumstance. A varus-producing DFO could be a wonderful option to improve pain and performance in patients with isolated lateral compartment disease and valgus alignment.

Sean Teale