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Updated: Feb 6, 2026

Three-Dimensional Preoperative Virtual Planning in Derotational Proximal Femoral Osteotomy
Published on: February 17, 2023
Additional distal femoral osteotomy for insufficient correction after high tibial osteotomy
Ryuichi Nakamura1, Kazunari Kuroda2, Masaki Takahashi2
1Department of Orthopaedic Surgery, Joint Preservation and Sports Orthopaedic Center, Harue Hospital, Sakai, Fukui, Japan.
Abstract:
A 70-year-old man who was treated with a closed-wedge high tibial osteotomy (HTO) had recurrent right medial knee pain 12 years after the initial osteotomy. We planned a recorrection osteotomy because the patient led an active lifestyle, had well-preserved range of motion and the lateral compartment was still intact. According to preoperative deformity analysis, which indicated a tibia in slight valgus and a femur in moderate varus, recorrection of the distal femur was chosen. Seven degrees of biplanar distal femoral osteotomy (DFO) was performed using a contralateral version of the TomoFix Medial Distal Femur. At 1 year follow-up, the femorotibial angle had improved from 178° to 170°, and the Japanese Orthopaedic Association score had improved from 75 to 95 points. Additional DFO could be a viable alternative for total knee arthroplasty or recorrection HTO when the centre of the deformity is located at the distal femur.
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