Distal Femoral Osteotomy and Lateral Meniscus Allograft Transplant

Distal femoral varus-producing osteotomy can be performed in the setting of lateral meniscal transplant to correct valgus malalignment of the knee and thus offload the lateral compartment. Advantages of a lateral opening wedge over medial closing wedge osteotomy include a single bone cut, avoidance of vascular structures, and theoretically better control of the amount of correction. It is important to address all knee joint comorbidities, including meniscal deficiency, chondral and osteochondral defects, and ligamentous insufficiency. This article reviews indications, preoperative considerations, technique, postoperative rehabilitative protocol, and results in the literature associated with concurrent varus-producing distal femoral osteotomy and lateral meniscal transplant.