Volume 12, Issue 3 (Summer 2025)
JROS 2025, 12(3): 135-144 |
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Bagherifard A, Jabalameli M, Askari A, Yahyazadeh H, Zareie B, Heidarikhoo M et al . Origin-specific Osteotomy for the Correction of Genu Valgum Deformity of the Knee: A Retrospective Study. JROS 2025; 12 (3) :135-144
URL: http://jros.iums.ac.ir/article-1-2306-en.html
URL: http://jros.iums.ac.ir/article-1-2306-en.html
Abolfazl Bagherifard1 
, Mahmoud Jabalameli1 , Alireza Askari1 , Hooman Yahyazadeh2 , Bushra Zareie1 , Mohammadreza Heidarikhoo1 , Behnam Sour1
, Mahmoud Jabalameli1 , Alireza Askari1 , Hooman Yahyazadeh2 , Bushra Zareie1 , Mohammadreza Heidarikhoo1 , Behnam Sour1
1- Bone and Joint Reconstruction Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
2- Department of Orthopedics, TMS.C., Islamic Azad University, Tehran, Iran.
2- Department of Orthopedics, TMS.C., Islamic Azad University, Tehran, Iran.
Abstract: (14 Views)
Background: Valgus deformity in adults may originate from the distal femur, proximal tibia, or a combined pattern. Correcting a deformity at the wrong anatomical level may improve the mechanical axis but leave the joint line oblique, potentially affecting load distribution and symptoms.
Objectives: This study evaluated an origin-directed osteotomy strategy using long-leg radiographic measurements.
Methods: Thirty-one patients (34 knees) with symptomatic genu valgum underwent deformity analysis based on the lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), and joint-line convergence angle (JLCA). According to the dominant radiographic deviation, patients were treated with distal femoral osteotomy (DFO), proximal tibial osteotomy (PTO), or double-level correction. Radiographic outcomes, knee range of motion (ROM), KOOS, WOMAC, and complications were assessed at a mean follow-up of 4.2 years.
Results: Most deformities were femoral-based (76.5%), followed by combined (17.6%) and tibial-based (5.9%) patterns. LDFA improved from 80.5° to 86.8° (P<0.001), JLCA from −3.44° to 3.2° (P<0.001), and the valgus angle from 14° to 6.5° (P<0.001). MPTA did not change significantly (90.4° to 89.8°, P=0.10). At final follow-up, mean KOOS was 79.6 and mean WOMAC was 23.5. Seven knees (20.6%) underwent elective plate removal, and one nonunion (2.9%) occurred. No postoperative joint-line obliquity or recurrent valgus was observed.
Conclusion: Assigning correction to the anatomical origin of valgus deformity resulted in accurate coronal realignment, preservation of joint-line orientation, and satisfactory mid-term outcomes. Origin-specific planning based on long-leg radiographs is a practical and reproducible strategy for adult valgus correction.
Objectives: This study evaluated an origin-directed osteotomy strategy using long-leg radiographic measurements.
Methods: Thirty-one patients (34 knees) with symptomatic genu valgum underwent deformity analysis based on the lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), and joint-line convergence angle (JLCA). According to the dominant radiographic deviation, patients were treated with distal femoral osteotomy (DFO), proximal tibial osteotomy (PTO), or double-level correction. Radiographic outcomes, knee range of motion (ROM), KOOS, WOMAC, and complications were assessed at a mean follow-up of 4.2 years.
Results: Most deformities were femoral-based (76.5%), followed by combined (17.6%) and tibial-based (5.9%) patterns. LDFA improved from 80.5° to 86.8° (P<0.001), JLCA from −3.44° to 3.2° (P<0.001), and the valgus angle from 14° to 6.5° (P<0.001). MPTA did not change significantly (90.4° to 89.8°, P=0.10). At final follow-up, mean KOOS was 79.6 and mean WOMAC was 23.5. Seven knees (20.6%) underwent elective plate removal, and one nonunion (2.9%) occurred. No postoperative joint-line obliquity or recurrent valgus was observed.
Conclusion: Assigning correction to the anatomical origin of valgus deformity resulted in accurate coronal realignment, preservation of joint-line orientation, and satisfactory mid-term outcomes. Origin-specific planning based on long-leg radiographs is a practical and reproducible strategy for adult valgus correction.
Keywords: Genu valgum, Valgus deformity, Distal femoral osteotomy (DFO), Proximal tibial osteotomy (PTO), Long-leg radiographs, Joint-line orientation, Coronal realignment, Knee osteotomy
Type of Study: Research Article |
Subject:
Knee surgery
Received: 2025/03/1 | Accepted: 2025/05/22 | Published: 2025/08/1
Received: 2025/03/1 | Accepted: 2025/05/22 | Published: 2025/08/1
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