Research progress of osteotomy around knee in the treatment of valgus knee osteoarthritis_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIU Yunfei ¹ , XIE Xuetao ² ,  LUO Congfeng ²

1. Department of Orthopedics, the Affiliated Suzhou Science & Technology Town Hospital of Nanjing Medical University, Suzhou Jiangsu, 215000, P. R. China;
2. Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233, P. R. China;

Corresponding author：

LUO Congfeng, Email: congfengl@outlook.com

Keywords：

Knee joint; knee valgus; osteoarthritis; osteotomy

DOI：

10.7507/1002-1892.202108009

Video：

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Objective To review the research progress of surgical methods of osteotomy around the knee in the treatment of valgus knee osteoarthritis. Methods The relevant literature on the surgical treatment of valgus knee osteoarthritis at home and abroad in recent years was reviewed, and the advantages, disadvantages, and effectiveness of different surgical methods of osteotomy around the knee were summarized. Results For young and active patients with symptomatic valgus knee osteoarthritis, osteotomy around the knee is a safe and reliable treatment option. At present, the main surgical methods include medial closing wedge distal femoral osteotomy, lateral opening wedge distal femoral osteotomy, medial closing wedge high tibial osteotomy, and lateral opening wedge high tibial osteotomy. The indications, advantages, and disadvantages of different osteotomies are different, and the selection of appropriate surgical method is the key to achieve good effectiveness. Conclusion There are many osteotomies in the treatment of valgus knee osteoarthritis. In order to achieve good results, improve survival rate, and reduce postoperative complications, the most reasonable surgical strategy needs to be developed according to different situations.

Citation： LIU Yunfei, XIE Xuetao, LUO Congfeng. Research progress of osteotomy around knee in the treatment of valgus knee osteoarthritis. Chinese Journal of Reparative and Reconstructive Surgery, 2022, 36(1): 111-116. doi: 10.7507/1002-1892.202108009 Copy

1.	熊华章, 曾羿, 斯海波, 等. 膝内侧间室骨关节炎单髁置换术有限元分析研究进展. 中国修复重建外科杂志, 2021, 35(6): 781-785.
2.	王波, 余楠生. 膝骨关节炎阶梯治疗专家共识 (2018年版). 中华关节外科杂志 (电子版), 2019, 13(1): 124-130.
3.	Sharma L, Song J, Dunlop D, et al. Varus and valgus alignment and incident and progressive knee osteoarthritis. Ann Rheum Dis, 2010, 69(11): 1940-1945.
4.	Sherman SL, Thompson SF, Clohisy JCF. Distal femoral varus osteotomy for the management of valgus deformity of the knee. J Am Acad Orthop Surg, 2018, 26(9): 313-324.
5.	Duethman NC, Bernard CD, Camp CL, et al. Medial closing wedge distal femoral osteotomy. Clin Sports Med, 2019, 38(3): 361-373.
6.	Forkel P, Achtnich A, Metzlaff S, et al. Midterm results following medial closed wedge distal femoral osteotomy stabilized with a locking internal fixation device. Knee Surg Sports Traumatol Arthrosc, 2015, 23(7): 2061-2067.
7.	Buda R, Castagnini F, Gorgolini G, et al. Distal femoral medial closing wedge osteotomy for degenerative valgus knee: mid-term results in active patients. Acta Orthop Belg, 2017, 83(1): 140-145.
8.	Uquillas C, Rossy W, Nathasingh CK, et al. Osteotomies about the knee: AAOS exhibit selection. J Bone Joint Surg (Am), 2014, 96(24): e199. doi: 10.2106/JBJS.N.00270.
9.	Shi J, Lv W, Wang Y, et al. Three dimensional patient-specific printed cutting guides for closing-wedge distal femoral osteotomy. Int Orthop, 2019, 43(3): 619-624.
10.	Wang JW, Hsu CC. Distal femoral varus osteotomy for osteoarthritis of the knee. Surgical technique. J Bone Joint Surg (Am), 2006, 88 Suppl 1 Pt 1: 100-108.
11.	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(9): e488-490.
12.	Backstein D, Morag G, Hanna S, et al. Long-term follow-up of distal femoral varus osteotomy of the knee. J Arthroplasty, 2007, 22(4 Suppl 1): 2-6.
13.	Duerr RA, Harangody S, Magnussen RA, et al. Technique for biplanar lateral opening wedge distal femoral osteotomy in the valgus knee. Arthrosc Tech, 2020, 9(9): e1323-e1333.
14.	Jacobi M, Wahl P, Bouaicha S, et al. Distal femoral varus osteotomy: problems associated with the lateral open-wedge technique. Arch Orthop Trauma Surg, 2011, 131(6): 725-728.
15.	Saithna A, Kundra R, Getgood A, et al. Opening wedge distal femoral varus osteotomy for lateral compartment osteoarthritis in the valgus knee. Knee, 2014, 21(1): 172-175.
16.	Kolb A, Isak V, Hobusch GM, et al. Distal femoral varus osteotomy: results of the lateral open-wedge technique without bone grafting. Int Orthop, 2019, 43(10): 2315-2322.
17.	Dewilde TR, Dauw J, Vandenneucker H, et al. Opening wedge distal femoral varus osteotomy using the Puddu plate and calcium phosphate bone cement. Knee Surg Sports Traumatol Arthrosc, 2013, 21(1): 249-254.
18.	Brinkman JM, Hurschler C, Agneskirchner JD, et al. Axial and torsional stability of supracondylar femur osteotomies: biomechanical comparison of the stability of five different plate and osteotomy configurations. Knee Surg Sports Traumatol Arthrosc, 2011, 19(4): 579-587.
19.	Elattar O, Swarup I, Lam A, et al. Open wedge distal femoral osteotomy: Accuracy of correction and patient outcomes. HSS J, 2017, 13(2): 128-135.
20.	Kim YC, Yang JH, Kim HJ, et al. Distal femoral varus osteotomy for valgus arthritis of the knees: Systematic review of open versus closed wedge osteotomy. Knee Surg Relat Res, 2018, 30(1): 3-16.
21.	Madelaine A, Lording T, Villa V, et al. The effect of lateral opening wedge distal femoral osteotomy on leg length. Knee Surg Sports Traumatol Arthrosc, 2016, 24(3): 847-854.
22.	Ekeland A, Nerhus TK, Dimmen S, et al. Better functional results of opening wedge HTO for varus knees with medial osteoarthritis than opening wedge LFO for valgus knees with lateral osteoarthritis. Bone Jt Open, 2020, 1(7): 346-354.
23.	Wylie JD, Jones DL, Hartley MK, et al. Distal femoral osteotomy for the valgus knee: medial closing wedge versus lateral opening wedge: A systematic review. Arthroscopy, 2016, 32(10): 2141-2147.
24.	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(6): 2325967116649901. doi: 10.1177/2325967116649901.
25.	Voleti PB, Wu IT, Degen RM, et al. Successful return to sport following distal femoral varus osteotomy. Cartilage, 2019, 10(1): 19-25.
26.	Shivji FS, Foster A, Risebury MJ, et al. Ten-year survival rate of 89% after distal femoral osteotomy surgery for lateral compartment osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc, 2021, 29(2): 594-599.
27.	Mayfield CK, Bolia IK, Mayer EN, et al. Factors associated with distal femoral osteotomy survivorship: Data from the california office of statewide health planning and development (OSHPD) registry. Orthop J Sports Med, 2020, 8(9): 2325967120951554. doi: 10.1177/2325967120951554.
28.	Vena G, D’Adamio S, Amendola A. Complications of osteotomies about the knee. Sports Med Arthrosc Rev, 2013, 21(2): 113-120.
29.	Puddu G, Cipolla M, Cerullo G, et al. Which osteotomy for a valgus knee? Int Orthop, 2010, 34(2): 239-247.
30.	Pilone C, Rosso F, Cottino U, et al. Lateral opening wedge distal femoral osteotomy for lateral compartment arthrosis/overload. Clin Sports Med, 2019, 38(3): 351-359.
31.	O’Malley MP, Pareek A, Reardon PJ, et al. Distal femoral osteotomy: Lateral opening wedge technique. Arthrosc Tech, 2016, 5(4): e725-e730.
32.	Duerr RA, Harangody S, Magnussen RA, et al. Technique for medial closing-wedge proximal tibia osteotomy in the valgus knee. Arthrosc Tech, 2020, 9(7): e925-e933.
33.	Collins B, Getgood A, Alomar AZ, et al. A case series of lateral opening wedge high tibial osteotomy for valgus malalignment. Knee Surg Sports Traumatol Arthrosc, 2013, 21(1): 152-160.
34.	Marti RK, Verhagen RA, Kerkhoffs GM, et al. Proximal tibial varus osteotomy. Indications, technique, and five to twenty-one-year results. J Bone Joint Surg (Am), 2001, 83(2): 164-170.
35.	Coventry MB. Proximal tibial varus osteotomy for osteoarthritis of the lateral compartment of the knee. J Bone Joint Surg (Am), 1987, 69(1): 32-38.
36.	Shoji H, Insall J. High tibial osteotomy for osteoarthritis of the knee with valgus deformity. J Bone Joint Surg (Am), 1973, 55(5): 963-973.
37.	Chambat P, Ait Si Selmi T, Dejour D, et al. Varus tibial osteotomy. Oper Tech Sports Med, 2000, 8(1): 44-47.
38.	Mirouse G, Dubory A, Roubineau F, et al. Failure of high tibial varus osteotomy for lateral tibio-femoral osteoarthritis with <10° of valgus: Outcomes in 19 patients. Orthop Traumatol Surg Res, 2017, 103(6): 953-958.
39.	Eberbach H, Mehl J, Feucht MJ, et al. Geometry of the valgus knee: Contradicting the dogma of a femoral-based deformity. Am J Sports Med, 2017, 45(4): 909-914.

1. 熊华章, 曾羿, 斯海波, 等. 膝内侧间室骨关节炎单髁置换术有限元分析研究进展. 中国修复重建外科杂志, 2021, 35(6): 781-785.
2. 王波, 余楠生. 膝骨关节炎阶梯治疗专家共识 (2018年版). 中华关节外科杂志 (电子版), 2019, 13(1): 124-130.
3. Sharma L, Song J, Dunlop D, et al. Varus and valgus alignment and incident and progressive knee osteoarthritis. Ann Rheum Dis, 2010, 69(11): 1940-1945.
4. Sherman SL, Thompson SF, Clohisy JCF. Distal femoral varus osteotomy for the management of valgus deformity of the knee. J Am Acad Orthop Surg, 2018, 26(9): 313-324.
5. Duethman NC, Bernard CD, Camp CL, et al. Medial closing wedge distal femoral osteotomy. Clin Sports Med, 2019, 38(3): 361-373.
6. Forkel P, Achtnich A, Metzlaff S, et al. Midterm results following medial closed wedge distal femoral osteotomy stabilized with a locking internal fixation device. Knee Surg Sports Traumatol Arthrosc, 2015, 23(7): 2061-2067.
7. Buda R, Castagnini F, Gorgolini G, et al. Distal femoral medial closing wedge osteotomy for degenerative valgus knee: mid-term results in active patients. Acta Orthop Belg, 2017, 83(1): 140-145.
8. Uquillas C, Rossy W, Nathasingh CK, et al. Osteotomies about the knee: AAOS exhibit selection. J Bone Joint Surg (Am), 2014, 96(24): e199. doi: 10.2106/JBJS.N.00270.
9. Shi J, Lv W, Wang Y, et al. Three dimensional patient-specific printed cutting guides for closing-wedge distal femoral osteotomy. Int Orthop, 2019, 43(3): 619-624.
10. Wang JW, Hsu CC. Distal femoral varus osteotomy for osteoarthritis of the knee. Surgical technique. J Bone Joint Surg (Am), 2006, 88 Suppl 1 Pt 1: 100-108.
11. 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(9): e488-490.
12. Backstein D, Morag G, Hanna S, et al. Long-term follow-up of distal femoral varus osteotomy of the knee. J Arthroplasty, 2007, 22(4 Suppl 1): 2-6.
13. Duerr RA, Harangody S, Magnussen RA, et al. Technique for biplanar lateral opening wedge distal femoral osteotomy in the valgus knee. Arthrosc Tech, 2020, 9(9): e1323-e1333.
14. Jacobi M, Wahl P, Bouaicha S, et al. Distal femoral varus osteotomy: problems associated with the lateral open-wedge technique. Arch Orthop Trauma Surg, 2011, 131(6): 725-728.
15. Saithna A, Kundra R, Getgood A, et al. Opening wedge distal femoral varus osteotomy for lateral compartment osteoarthritis in the valgus knee. Knee, 2014, 21(1): 172-175.
16. Kolb A, Isak V, Hobusch GM, et al. Distal femoral varus osteotomy: results of the lateral open-wedge technique without bone grafting. Int Orthop, 2019, 43(10): 2315-2322.
17. Dewilde TR, Dauw J, Vandenneucker H, et al. Opening wedge distal femoral varus osteotomy using the Puddu plate and calcium phosphate bone cement. Knee Surg Sports Traumatol Arthrosc, 2013, 21(1): 249-254.
18. Brinkman JM, Hurschler C, Agneskirchner JD, et al. Axial and torsional stability of supracondylar femur osteotomies: biomechanical comparison of the stability of five different plate and osteotomy configurations. Knee Surg Sports Traumatol Arthrosc, 2011, 19(4): 579-587.
19. Elattar O, Swarup I, Lam A, et al. Open wedge distal femoral osteotomy: Accuracy of correction and patient outcomes. HSS J, 2017, 13(2): 128-135.
20. Kim YC, Yang JH, Kim HJ, et al. Distal femoral varus osteotomy for valgus arthritis of the knees: Systematic review of open versus closed wedge osteotomy. Knee Surg Relat Res, 2018, 30(1): 3-16.
21. Madelaine A, Lording T, Villa V, et al. The effect of lateral opening wedge distal femoral osteotomy on leg length. Knee Surg Sports Traumatol Arthrosc, 2016, 24(3): 847-854.
22. Ekeland A, Nerhus TK, Dimmen S, et al. Better functional results of opening wedge HTO for varus knees with medial osteoarthritis than opening wedge LFO for valgus knees with lateral osteoarthritis. Bone Jt Open, 2020, 1(7): 346-354.
23. Wylie JD, Jones DL, Hartley MK, et al. Distal femoral osteotomy for the valgus knee: medial closing wedge versus lateral opening wedge: A systematic review. Arthroscopy, 2016, 32(10): 2141-2147.
24. 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(6): 2325967116649901. doi: 10.1177/2325967116649901.
25. Voleti PB, Wu IT, Degen RM, et al. Successful return to sport following distal femoral varus osteotomy. Cartilage, 2019, 10(1): 19-25.
26. Shivji FS, Foster A, Risebury MJ, et al. Ten-year survival rate of 89% after distal femoral osteotomy surgery for lateral compartment osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc, 2021, 29(2): 594-599.
27. Mayfield CK, Bolia IK, Mayer EN, et al. Factors associated with distal femoral osteotomy survivorship: Data from the california office of statewide health planning and development (OSHPD) registry. Orthop J Sports Med, 2020, 8(9): 2325967120951554. doi: 10.1177/2325967120951554.
28. Vena G, D’Adamio S, Amendola A. Complications of osteotomies about the knee. Sports Med Arthrosc Rev, 2013, 21(2): 113-120.
29. Puddu G, Cipolla M, Cerullo G, et al. Which osteotomy for a valgus knee? Int Orthop, 2010, 34(2): 239-247.
30. Pilone C, Rosso F, Cottino U, et al. Lateral opening wedge distal femoral osteotomy for lateral compartment arthrosis/overload. Clin Sports Med, 2019, 38(3): 351-359.
31. O’Malley MP, Pareek A, Reardon PJ, et al. Distal femoral osteotomy: Lateral opening wedge technique. Arthrosc Tech, 2016, 5(4): e725-e730.
32. Duerr RA, Harangody S, Magnussen RA, et al. Technique for medial closing-wedge proximal tibia osteotomy in the valgus knee. Arthrosc Tech, 2020, 9(7): e925-e933.
33. Collins B, Getgood A, Alomar AZ, et al. A case series of lateral opening wedge high tibial osteotomy for valgus malalignment. Knee Surg Sports Traumatol Arthrosc, 2013, 21(1): 152-160.
34. Marti RK, Verhagen RA, Kerkhoffs GM, et al. Proximal tibial varus osteotomy. Indications, technique, and five to twenty-one-year results. J Bone Joint Surg (Am), 2001, 83(2): 164-170.
35. Coventry MB. Proximal tibial varus osteotomy for osteoarthritis of the lateral compartment of the knee. J Bone Joint Surg (Am), 1987, 69(1): 32-38.
36. Shoji H, Insall J. High tibial osteotomy for osteoarthritis of the knee with valgus deformity. J Bone Joint Surg (Am), 1973, 55(5): 963-973.
37. Chambat P, Ait Si Selmi T, Dejour D, et al. Varus tibial osteotomy. Oper Tech Sports Med, 2000, 8(1): 44-47.
38. Mirouse G, Dubory A, Roubineau F, et al. Failure of high tibial varus osteotomy for lateral tibio-femoral osteoarthritis with <10° of valgus: Outcomes in 19 patients. Orthop Traumatol Surg Res, 2017, 103(6): 953-958.
39. Eberbach H, Mehl J, Feucht MJ, et al. Geometry of the valgus knee: Contradicting the dogma of a femoral-based deformity. Am J Sports Med, 2017, 45(4): 909-914.

Chinese Journal of Reparative and Reconstructive Surgery

Research progress of osteotomy around knee in the treatment of valgus knee osteoarthritis

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