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Askari A, Jabalameli M, Moghtadaei M, Yahyazadeh H, Gholami E, Zareie B et al . Mid-term Outcomes After Lateral Opening-Wedge Distal Femoral Osteotomy With Locking Plate Fixation for Symptomatic Valgus Knees: A Retrospective Cohort Study. JROS 2026; 13 (2)
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- Bone and Joint Reconstruction Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
2- Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
3- Department of Orthopedics, Islamic Azad University, Tehran, Iran
2- Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
3- Department of Orthopedics, Islamic Azad University, Tehran, Iran
Abstract: (2 Views)
Background and Objective: Distal femoral osteotomy (DFO) is a joint-preserving procedure for symptomatic valgus knees. 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 hip–knee–ankle (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 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.
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 hip–knee–ankle (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 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: 2026/05/4 | Accepted: 2026/05/4 | Published: 2026/07/19
Received: 2026/05/4 | Accepted: 2026/05/4 | Published: 2026/07/19
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