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DOI: 10.1055/s-0040-1716765
Long Term Outcomes of Computer-Navigated Lateral Opening Wedge Distal Femoral Osteotomy for Lateral Compartment Knee Arthrosis[*]
Artikel in mehreren Sprachen: português | English
Abstract
Objective The primary aim of the present study was to evaluate the long-term outcomes including survivorship of computer navigated distal femoral lateral opening wedge osteotomy (DFLOWO). The secondary aim was to identify the potential factors that may influence its survivorship.
Methods A retrospective analysis of prospectively collected data for patients with lateral compartment arthritis who underwent navigated DFLOWO from December 2006 to November 2012 was performed. The International Knee Documentation Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Score (KOOS) scores were analyzed for outcome measures. Conversion to arthroplasty during the follow-up was the end point.
Results A total of 19 DFLOWOs were performed in 17 patients with a mean age of 46.6 ± 6.5 years formed the study cohort. The coronal alignment was corrected from a mean of 7.1° (2–11°) valgus to a mean of 2.1° (0.5°–3°) varus. The IKDC scores improved from mean of 39 preoperatively to 53 at the mean long-term follow-up of 9.1 years. The mean KOOS scores at the long-term follow-up were pain 71, symptoms 56, activities of daily living 82, sports and recreation 59, quality of life 43. Survivorship of the DFLOWO was 78.9% at a follow-up of 9.1 years. Presence of ≥ grade 2 according to the International Cartilage Repair Society (ICRS) cartilage degeneration in the medial compartment of the knee and >7° preoperative valgus deformity were strongly correlated with conversion to total knee arthroplasty (TKA) at the long-term follow-up (r = 0.66).
Conclusions Computer navigated DFLOWO has satisfactory clinical outcomes and 79% survivorship in long-term follow-up. Presence of more than ICRS ≥ grade 2 degenerative changes in the medial compartment of knee with > 7° preoperative valgus deformity negatively affects the survivorship of DFLOWO in the long-term follow-up.
Authors' contributions
All the authors contributed to the formulation of the idea and study protocol, data collection, statistical analyses, analyses of the results and writing of the manuscript.
Abbreviations
Osteotomy of distal femur (DFO), distal femur lateral opening-wedge osteotomy (DFLOWO), distal femur medial closing wedge osteotomy (DFMCWO), body mass index (BMI), International Knee Documentation Committee (IKDC), Knee Injury and Osteoarthritis Outcome Score (KOOS), Total knee arthroplasty (TKA), Uni-compartmental knee arthroplasty (UKA), International Cartilage Repair Society (ICRS), Computer assisted surgery (CAS).
* Work developed at Orthopaedic Knee surgery, Sydney Orthopaedic Research Institute, Chatswood, Sydney, NSW, Australia.
Publikationsverlauf
Eingereicht: 17. Mai 2020
Angenommen: 06. Juli 2020
Artikel online veröffentlicht:
30. September 2020
© 2020. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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Referências
- 1 Ekeland A, Nerhus TK, Dimmen S, Heir S. Good functional results of distal femoral opening-wedge osteotomy of knees with lateral osteoarthritis. Knee Surg Sports Traumatol Arthrosc 2016; 24 (05) 1702-1709
- 2 Chahla J, Mitchell JJ, Liechti DJ. et al. Opening-and closing-wedge distal femoral osteotomy: a systematic review of outcomes for isolated lateral compartment osteoarthritis. Orthop J Sports Med 2016; 4 (06) 2325967116649901
- 3 Dewilde TR, Dauw J, Vandenneucker H, Bellemans J. Opening wedge distal femoral varus osteotomy using the Puddu plate and calcium phosphate bone cement. Knee Surg Sports Traumatol Arthrosc 2013; 21 (01) 249-254
- 4 Jacobi M, Wahl P, Bouaicha S, Jakob RP, Gautier E. Distal femoral varus osteotomy: problems associated with the lateral open-wedge technique. Arch Orthop Trauma Surg 2011; 131 (06) 725-728
- 5 Thein R, Bronak S, Thein R, Haviv B. Distal femoral osteotomy for valgus arthritic knees. J Orthop Sci 2012; 17 (06) 745-749
- 6 Zarrouk A, Bouzidi R, Karray B, Kammoun S, Mourali S, Kooli M. Distal femoral varus osteotomy outcome: Is associated femoropatellar osteoarthritis consequential?. Orthop Traumatol Surg Res 2010; 96 (06) 632-636
- 7 Backstein D, Morag G, Hanna S, Safir O, Gross A. Long-term follow-up of distal femoral varus osteotomy of the knee. J Arthroplasty 2007; 22 (04, Suppl 1): 2-6
- 8 Finkelstein JA, Gross AE, Davis A. Varus osteotomy of the distal part of the femur. A survivorship analysis. J Bone Joint Surg Am 1996; 78 (09) 1348-1352
- 9 Sternheim A, Garbedian S, Backstein D. Distal femoral varus osteotomy: unloading the lateral compartment: long-term follow-up of 45 medial closing wedge osteotomies. Orthopedics 2011; 34 (09) e488-e490
- 10 Kosashvili Y, Safir O, Gross A, Morag G, Lakstein D, Backstein D. Distal femoral varus osteotomy for lateral osteoarthritis of the knee: a minimum ten-year follow-up. Int Orthop 2010; 34 (02) 249-254
- 11 Forkel P, Achtnich A, Metzlaff S, Zantop T, Petersen W. Midterm results following medial closed wedge distal femoral osteotomy stabilized with a locking internal fixation device. Knee Surg Sports Traumatol Arthrosc 2015; 23 (07) 2061-2067
- 12 Wang JW, Hsu CC. Distal femoral varus osteotomy for osteoarthritis of the knee. J Bone Joint Surg Am 2005; 87 (01) 127-133
- 13 Paccola CAJ. Pre-operative planning and surgical technique of the open wedge supracondylar osteotomy for correction of valgus knee and fixation with a fixed-angle implant. Rev Bras Ortop 2015; 45 (06) 627-635
- 14 Elattar O, Swarup I, Lam A, Nguyen J, Fragomen A, Rozbruch SR. Open wedge distal femoral osteotomy: accuracy of correction and patient outcomes. HSS J 2017; 13 (02) 128-135
- 15 Lee SH, Song EK, Seon JK. Navigation system provides better functional outcomes of total knee arthroplasty. Form J Musculoskel Dis 2016; 7 (01) 8-16
- 16 Reising K, Strohm PC, Hauschild O. et al. Computer-assisted navigation for the intraoperative assessment of lower limb alignment in high tibial osteotomy can avoid outliers compared with the conventional technique. Knee Surg Sports Traumatol Arthrosc 2013; 21 (01) 181-188
- 17 Akamatsu Y, Mitsugi N, Mochida Y. et al. Navigated opening wedge high tibial osteotomy improves intraoperative correction angle compared with conventional method. Knee Surg Sports Traumatol Arthrosc 2012; 20 (03) 586-593
- 18 Ribeiro CH, Severino NR, Moraes de Barros Fucs PM. Opening wedge high tibial osteotomy: navigation system compared to the conventional technique in a controlled clinical study. Int Orthop 2014; 38 (08) 1627-1631
- 19 The Australian Orthopaedic Association National Joint Replacement Registry. Ad Hoc Report. Adelaide, Australia: AOA; 2019
- 20 Irrgang JJ, Anderson AF, Boland AL. et al. Development and validation of the international knee documentation committee subjective knee form. Am J Sports Med 2001; 29 (05) 600-613
- 21 Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD. Knee Injury and Osteoarthritis Outcome Score (KOOS)–development of a self-administered outcome measure. J Orthop Sports Phys Ther 1998; 28 (02) 88-96
- 22 Saragaglia D, Chedal-Bornu B. Computer-assisted osteotomy for valgus knees: medium-term results of 29 cases. Orthop Traumatol Surg Res 2014; 100 (05) 527-530
- 23 Shivji FS, Foster A, Risebury MJ, Wilson AJ, Yasen SK. Ten-year survival rate of 89% after distal femoral osteotomy surgery for lateral compartment osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc 2020; DOI: 10.1007/s00167-020-05988-5.