Acta Scientific Orthopaedics (ISSN: 2581-8635)

Research Article Volume 4 Issue 2

Cartilage Regeneration in Knees with Lateral Unicompartmental Osteoarthritis Following Distal Femoral Varus Osteotomy

Yueh-cheng Tsai*, Cheng-han Ho, Tzu-hao Tseng, Hongsen Chiang and Jyh-horng Wang

Department of Orthopaedic Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taiwan

*Corresponding Author: Yueh-cheng Tsai, Department of Orthopaedic Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taiwan.

Received: November 30, 2020; Published: January 16, 2021

×

Abstract

  Valgus deformity of the knee joint leading to lateral unicompartmental osteoarthritis is challenging for orthopedic surgeons. We aimed to clarify the characteristics of cartilage regeneration over the lateral compartment after arthroscopic subchondral drilling with concomitant distal femoral varus osteotomy (DFVO) and assess limb alignment correction postoperatively. Thirty knees were operated on, and the clinical outcomes and severity of lateral knee pain were evaluated. The major finding was that degenerative articular cartilage was partially or fully regenerated, and functional improvement and lower limb alignment correction were achieved after DFVO. The data suggested that DFVO achieves functional improvement and pain relief. With careful preoperative planning and intraoperative procedures, optimal angle correction can be achieved. In conclusion, DFVO with concomitant subchondral drilling provides reliable mechanical alignment as well as considerable cartilage regeneration over the lateral compartment.

Keywords: Distal Femoral Varus Osteotomy; Cartilage Regeneration; Mechanical Tibiofemoral Angle; Mechanical Lateral Distal Femoral Angle; Weight Bearing Line

×

References

  1. Santaguida PL., et al. “Patient characteristics affecting the prognosis of total hip and knee joint arthroplasty: a systematic review”. Canadian Journal of Surgery6 (2008): 428-436.
  2. Hanssen AD., et al. “Surgical options for the middle-aged patient with osteoarthritis of the knee joint”. Journal of Bone and Joint Surgery 82-A.12 (2000): 1768-1781.
  3. Backstein D., et al. “Long-term follow-up of distal femoral varus osteotomy of the knee”. Journal of Arthroplasty 22 (2007): 2-6.
  4. Kosashvili Y., et al. “Distal femoral varus osteotomy for lateral osteoarthritis of the knee: a minimum ten-year follow-up”. International Orthopaedics 34 (2010): 249-254.
  5. Cameron JI., et al. “Lateral opening-wedge distal femoral osteotomy: pain relief, functional improvement, and survivorship at 5 years”. Clinical Orthopaedics and Related Research 473 (2015): 2009-2015.
  6. Thein R., et al. “Distal femoral osteotomy for valgus arthritic knees”. Journal of Orthopaedic Science 17 (2012): 745-749.
  7. Lee OS., et al. “Effectiveness of concurrent procedures during high tibial osteotomy for medial compartment osteoarthritis: a systematic review and meta-analysis”. Archives of Orthopaedic and Trauma Surgery 2 (2018): 227-236.
  8. Gao L., et al. “Subchondral drilling for articular cartilage repair: a systematic review of translational research”. Disease Models and Mechanisms6 (2018).
  9. Olivero M., et al. “Femoral osteotomies for the valgus knee”. Annals of Joint 2 (2017): 31-44.
  10. Tírico LE., et al. “Medial closing-wedge distal femoral osteotomy: fixation with proximal tibial locking plate”. Arthroscopy Techniques6 (2015): 687-695.
  11. Koshino T., et al. “Regeneration of degenerated articular cartilage after high tibial valgus osteotomy for medial compartmental osteoarthritis of the knee”. Knee3 (2003): 229-236.
  12. Puddu G., et al. “Which osteotomy for a valgus knee?”. International Orthopaedics2 (2010): 239-247.
  13. Gardiner A and Richmond JC. “Periarticular osteotomies for degenerative joint disease of the knee”. Sports Medicine and Arthroscopy Review 1 (2013): 38-46.
  14. Jung WH., et al. “Comparison of results of medial opening-wedge high tibial osteotomy with and without subchondral drilling”. Arthroscopy 4 (2015): 673-679.
  15. Kim KI., et al. “Change of chondral lesions and predictive factors after medial open-wedge high tibial osteotomy with a locked plate system”. American Journal of Sports Medicine7 (2017): 1615-1621.
  16. Schuster P., et al. “Open-wedge high tibial osteotomy and combined abrasion/microfracture in severe medial osteoarthritis and varus malalignment: 5-year results and arthroscopic findings after 2 years”. Arthroscopy 7 (2015): 1279-1288.
  17. Song JS., et al. “Cartilage regeneration in osteoarthritic knees treated with distal femoral osteotomy and intra-lesional implantation of allogenic human umbilical cord blood-derived mesenchymal stem cells: a report of two cases”. Knee6 (2019): 1445-1450.
  18. Fransen M., et al. “The epidemiology of osteoarthritis in Asia”. International Journal of Rheumatic Diseases 2 (2011): 113-121.
  19. Lin FH., et al. “The increase in total knee replacement surgery in Taiwan”. Medicine 31 (2018): e11749.
×

Citation

Citation: Yueh-cheng Tsai., et al. “Cartilage Regeneration in Knees with Lateral Unicompartmental Osteoarthritis Following Distal Femoral Varus Osteotomy".Acta Scientific Orthopaedics 4.2 (2021): 09-14.




Metrics

Acceptance rate33%
Acceptance to publication20-30 days
Impact Factor0.614

Indexed In



News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is September 30, 2021.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of “Best Article of the Issue”.
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.
  • Contact US