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The effect of lateral opening wedge distal femoral osteotomy on leg length

Purpose Varisation distal femoral osteotomy is a welldescribed treatment for lateral compartment arthrosis in the young, active patient. This treatment may potentially alter the length of the lower limb. The objective of this study was to quantify the change in leg length following lateral opening wedge distal femoral osteotomy using a blade plate.

Methods Between 1998 and 2011, 29 lateral opening wedge distal femoral osteotomies were performed for symptomatic genu valgum with signs of lateral compartment arthrosis or patello-femoral symptoms. The mean age was 44.4 years (±11.3). Average follow-up was 80.2 months (±50.6).

Results The mean osteotomy opening was 8.3° (±2.3). The femoro-tibial mechanical axis (mFTA) was improved significantly, from 187.8° (±3.5) to 180.4° (±2.6) postoperatively ( p < 0.001). The pre-operative leg length discrepancy was −0.7 cm, compared to −0.6 cm postoperatively, which was not significant (n.s.). There were five revisions to arthroplasty for disease progression at meantime of 166.6 months post-operatively. The probability of survival at 60 months was 91.4 % (95 % CI 74.9– 100 %) with end-point of revision to total knee arthroplasty and 87.6 % (95 % CI 74.1–100 %) of revision for complications.