Results of forty two computer-assisted double level osteotomies for severe genu varum deformity

The goal of this article was to present the clinical and radiological results of 42 severe genu varum operated on between August 2001 and June 2010 using computer navigation.

All the osteotomies were navigated using the Orthopilot® device (B-Braun-Aesculap, Tuttlingen, Germany). The procedure was performed such that after inserting the rigid bodies and calibrating the lower leg, we first made the femoral closing wedge osteotomy (from four to seven mm) which was fixed by an AO T-Plate, and then, after checking the residual varus, the tibial opening wedge osteotomy was made using a Biosorb® wedge (Tricalcium phosphate, SBM, Lourdes, France) and a plate (AO T-plate or C-plate).

All the patients were assessed at a mean follow-up of 46 ± 27 months (range, 12-108). The mean Lyshölm-Tegner score was 83.3 ± 7.5 points (62-91) and the mean KOOS score was 95.1 ± 3.2 points (89-100). Forty patients were satisfied (22) or very satisfied (18) with the result. Regarding the radiological results, the goal was reached in 92.7% of cases and the mean HKA angle was 181.83° ± 1.80° (177-185°). At that mid-term follow-up no patient had revision to a total knee arthroplasty.

Computer-assisted double level osteotomy in severe genu varum is a reliable, reproducible, and accurate technique. This procedure, which is very delicate, especially in reaching pre-operative objectives, is simplified by computer-assistance.