Distal femoral medial closing wedge osteotomy for degenerative valgus knee : mid-term results in active patients.

ABSTRACT

Distal femoral medial closing wedge osteotomy (DFMCWO) may be a valuable treatment for arthritic valgus knees in young and active adults, with the possible aim of procrastinating knee replacement. 32 valgus knees (mean age  41.4±11.2) treated with DFMCWO were retrospectively reviewed. All the knees had a lateral compartment osteoarthritis graded I-II-III according to Kellgren Lawrence classification. 20 knees had osteochondral lesions, treated with microfractures (8) or bone marrow derived cells transplantation (12). Patients were clinically (IKDC, KOOS, NRS, Tegner) and radiologically evaluated. A mean follow-up of 62.12±15.65 was achieved. KOOS score peaked at 24 months, showed a decremental trend, achieved a final results of 79,59±17,14. Similar trend was evident for IKDC. The final NRS score was 2.73±1.82 ; the final Tegner score was 4.81±1.56. Radiographs showed degenerative progression in 5 knees  2 patients underwent knee replacement at the final follow-up. DFMCWO is an effective treatment to treat osteoarthritic symptomatology, delay degenerative progression and avoid knee replacement in valgus knees at mid-term follow-up.