Distal Femoral Osteotomy

Indications for Distal Femur Osteotomy

Malalignment of the bones at the knee joint may be present at birth or may occur due to trauma or arthritis. Two types of deformity usually occur:

• Genu varum: The tibia (shinbone) turns inwards in relation to the femur causing a bow-legged deformity.
• Genu valgus: The tibia turns outwards in relation to the femur causing a knock-knee deformity

A distal femoral osteotomy is recommended if you have a genu valgus deformity causing degeneration in the outer (lateral) part of the knee.

During a distal femoral osteotomy, the femur is lined up surgically so that the femoral axis passes through the center of the knee and pressure on the damaged side of the knee joint is relieved.

Procedure for Distal Femoral Osteotomy

Distal femoral osteotomy is usually performed under general anesthesia. The following technique is used:

• An incision is made over the distal femur where the osteotomy is to be performed. A medial closing wedge osteotomy is performed on the inside of the femur while a lateral opening wedge osteotomy is performed on the outside.
• The cut in the distal femur is made using an oscillating saw and a predetermined section of bone is removed.
• For a medial closing wedge osteotomy, a wedge-shaped section of bone is removed, and the opening is closed by bringing the cut ends of the bones together, thus changing the alignment of the bones.
• For a lateral opening wedge osteotomy, a wedge-shaped section of bone is removed, and the gap is opened further to change the alignment of the bones. A bone graft is inserted into the gap so that the bones fuse in the new alignment.
• The bones are secured in position with the help of metal plates and screws.
• The incision is closed, and healing occurs the same way a fracture heals.

Benefits of Distal Femoral Osteotomy

Distal femoral osteotomy can:

• Reduce knee pain significantly.
• Improve knee function.
• Delay the need for knee replacement.