Distal Femoral Osteotomy

An osteotomy is a surgical procedure that involves cutting and reshaping of a bone. Distal femoral osteotomy is indicated to correct deformities and malalignments such as valgus knee, a deformity where the knee angles out from the centre of the body. It is also performed to treat osteoarthritis in young active patients contraindicated for joint replacement.

Procedure

Prior to the surgery, Dr. Patel orders a series of imaging studies to estimate the extent of deformity and calculate the degree of correction for correct alignment of your legs. Mechanical alignment x-rays or radiographs are ordered which provide a scout view from the hips to the ankles. This allows Dr. Patel to check the overall alignment of the leg and calculate the amount of correction needed to offload the damaged area. A distal femoral osteotomy is performed under general or spinal anesthesia. A 4 to 6 cm incision is made in the upper leg near the knee from the side (laterally). The muscles and blood vessels are protected and the thigh bone is approached. Under fluoroscopy, a guide wire is inserted. With the help of an oscillating saw, a wedge is created and a wedge-shaped instrument with markings is inserted to measure and confirm the bone gap’s dimension. The correct alignment of your leg is confirmed. The bone is secured with a plate, a fixation device that provides stable fixation of the osteotomy. The plate is fixed to the bone with the help of screws. The wedge-shaped osteotomy defect is then filled with bone graft products. Once the correct alignment of your leg is confirmed, the muscles and blood vessels are released and the incision is sutured.

Risks

As with all surgical procedures, distal femoral osteotomy may be associated with certain complications such as infection, blood clots, delayed or nonunion of the bone and injuries to the surrounding blood vessels.