Volume 13, Issue 2 (Spring 2026)
JROS 2026, 13(2): 49-56 |
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Askari A, Jabalameli M, Moghtadaei M, Yahyazadeh H, Gholami E, Zareie B et al . Mid-term Outcomes of Lateral Opening-wedge Distal Femoral Osteotomy for Valgus Knees. JROS 2026; 13 (2) :49-56
URL: http://jros.iums.ac.ir/article-1-2322-en.html
URL: http://jros.iums.ac.ir/article-1-2322-en.html
Alireza Askari1 
, Mahmoud Jabalameli1 , Mehdi Moghtadaei2 , Hooman Yahyazadeh3 , Ehsan Gholami1 , Bushra Zareie1 , Behnam Sour1
, Mahmoud Jabalameli1 , Mehdi Moghtadaei2 , Hooman Yahyazadeh3 , Ehsan Gholami1 , Bushra Zareie1 , Behnam Sour1
1- Department of Orthopedics, Bone and Joint Reconstruction Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
2- Department of Orthopedics, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
3- Department of Orthopedic Surgery, Farhikhtegan Hospital, TeMS.C. Islamic Azad University, Tehran, Iran.
2- Department of Orthopedics, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
3- Department of Orthopedic Surgery, Farhikhtegan Hospital, TeMS.C. Islamic Azad University, Tehran, Iran.
Abstract: (544 Views)
Background: Distal femoral osteotomy (DFO) is a joint-preserving procedure for symptomatic valgus knees.
Objectives: This study aimed to evaluate radiographic correction, final patient-reported outcomes at mid-term follow-up, complications, and associated factors after lateral opening-wedge DFO fixed with a locking compression plate.
Methods: A retrospective cohort of 46 patients (46 knees) undergoing lateral opening-wedge DFO was reviewed. Mechanical alignment was assessed using the hip–knee–ankle (HKA) angle on standing long-leg radiographs. Pain and health-related quality of life at the final follow-up were measured using a visual analogue scale (VAS, 0–10) and the 36-item short form health survey (SF-36, 0–100). Complications and conversion to total knee arthroplasty (TKA) were recorded. Associations between baseline variables and outcomes were analyzed using correlation and group comparisons.
Results: Mean age was 38.30±10.14 years, and mean follow-up was 4.85±1.67 years. Mean HKA improved from 194.91±1.53° preoperatively to 180.33±0.87° at final follow-up (P<0.001). Final VAS was 2.11±1.10 and final SF-36 was 81.59±9.07. Complications occurred in 7 patients (15.22%), including nonunion in 6(13.04%) and conversion to TKA in 1(2.17%). Older age correlated with lower SF-36 (r=−0.36, P=0.01). Higher Kellgren–Lawrence (KL) grade was associated with worse SF-36 (P<0.001) and higher VAS (P=0.007).
Conclusion: Lateral opening-wedge DFO achieved consistent correction to near-neutral alignment with favorable outcomes. Nonunion was the most frequent complication, while TKA conversion was uncommon. Older age and greater osteoarthritis severity were associated with worse outcomes and increased risk of complications.
Objectives: This study aimed to evaluate radiographic correction, final patient-reported outcomes at mid-term follow-up, complications, and associated factors after lateral opening-wedge DFO fixed with a locking compression plate.
Methods: A retrospective cohort of 46 patients (46 knees) undergoing lateral opening-wedge DFO was reviewed. Mechanical alignment was assessed using the hip–knee–ankle (HKA) angle on standing long-leg radiographs. Pain and health-related quality of life at the final follow-up were measured using a visual analogue scale (VAS, 0–10) and the 36-item short form health survey (SF-36, 0–100). Complications and conversion to total knee arthroplasty (TKA) were recorded. Associations between baseline variables and outcomes were analyzed using correlation and group comparisons.
Results: Mean age was 38.30±10.14 years, and mean follow-up was 4.85±1.67 years. Mean HKA improved from 194.91±1.53° preoperatively to 180.33±0.87° at final follow-up (P<0.001). Final VAS was 2.11±1.10 and final SF-36 was 81.59±9.07. Complications occurred in 7 patients (15.22%), including nonunion in 6(13.04%) and conversion to TKA in 1(2.17%). Older age correlated with lower SF-36 (r=−0.36, P=0.01). Higher Kellgren–Lawrence (KL) grade was associated with worse SF-36 (P<0.001) and higher VAS (P=0.007).
Conclusion: Lateral opening-wedge DFO achieved consistent correction to near-neutral alignment with favorable outcomes. Nonunion was the most frequent complication, while TKA conversion was uncommon. Older age and greater osteoarthritis severity were associated with worse outcomes and increased risk of complications.
Keywords: Distal femoral osteotomy (DFO), Valgus knee, Lateral opening wedge, Alignment correction, Nonunion, 36-item short form health survey (SF-36)
Type of Study: Research Article |
Subject:
Knee surgery
Received: 2025/08/22 | Accepted: 2026/02/1 | Published: 2026/04/1
Received: 2025/08/22 | Accepted: 2026/02/1 | Published: 2026/04/1
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