CLINICAL AND RADIOOGICAL OUTCOME OF LATERAL OPEN WEDGE OSTEOTOMY FOR GENU VALGUM

Abstract

Background: Patients with Valgus deformity of Knee joint are candidates for lateral open wedge osteotomy. It is a precise technique to realign the mechanical axis of lower limb with good results. The purpose of the present study was to evaluate the outcome of patients who were treated with lateral distal open wedge osteotomy with Distal Femoral locking Plate using the Tricortical graft.

Methods: Prospective observational study at department of Orthopedic Surgery Services Hospital Lahore from Dec 2018 to Dec 2020. Our study consisted of 30 patients with Genu Valgum Deformity of knee joint. These patients were followed for 2 years after Lateral Open Wedge Osteotomy. The Osteotomy was fixed with Distal Femoral locking Plate with addition of Tricortical bone graft. Clinical results were assessed by using KOOS Score and Radiological evaluation was done with weight bearing full length X –rays of Hip, Knee and Ankle joint with Patella facing forward.

Results: The mean preoperative KOOS Score was 65(23.5-85) & post operatively it was 91.8(55-100) p=0.002. Mean mechanical axis deviation was-35.2( -75 to -12mm) preoperatively and it was-1.5 (-25 .1 to -10.5 mm) postoperatively p<0.002. The mean mechanical lateral distal femoral angle which was 80.0 valgus (72.5-82.5) preoperatively changed to 88.6 Degree (Range 87-90) postoperatively p = o.o25 which was statistically significant. The mean leg length discrepancy (LLD) -7.0mm (-20 to -8 mm) preoperatively while it was1.6mm after the surgery (-1o to 12mm) p< 0.002.

Conclusion: Lateral open wedge osteotomy using bone graft with distal femoral locking plate is a reliable and safe procedure with promising results in young patients having Genu Valgum deformity. It provides significant Patellar stability, limb lengthening with good functional & Radiological outcomes. It restores the normal joint congruity to prevent the lateral compartment degenerative changes at the knee joint.