Distal Femur Osteotomy to Correct (Knock-Knee) Deformity

Description

In this instructional video, Dr. Rob Rozbruch, Chief of Limb Lengthening and Complex Reconstruction Service, presents a detailed procedure on distal femoral osteotomy aimed at correcting valgus (knock-knee) deformities. The subject is a 25-year-old female with a left-sided valgus deformity of 9 degrees, experiencing lateral knee pain due to overload and risking progression to lateral knee arthritis. The surgical approach focuses on achieving full correction of the deformity and realigning the mechanical axis, which is shown to be misaligned by 26 millimeters in preliminary imaging.



The operation begins with a lateral incision to access the vastus lateralis and distal femur. Techniques for precise alignment and osteotomy are illustrated, including the use of a micro sagittal saw for cutting the bone, ensuring careful maneuvering to protect the medial cortex. An opening wedge is created at the osteotomy site, measured meticulously for optimal realignment according to preoperative plans, and the wedge size is confirmed to be 8 millimeters.



The procedure continues with the application of a carbon plate and the insertion of locking screws to stabilize the osteotomy. Intraoperative fluoroscopy checks confirm the correct alignment of the mechanical axis. Following stabilization, the opened wedge is grafted with freeze-dried allograft chips and demineralized bone matrix, promoting bone growth at the surgical site.



After closure of the incision in layers, follow-up x-rays three months post-operation show successful incorporation of the osteotomy and realignment of the mechanical axis. Dr. Rozbruch concludes with gratitude for the viewer's attention, emphasizing the effectiveness of the procedure.

Specialties