Bilateral Distal Femoral Osteotomy for Valgus Knee Deformity May Result in Improved Patient-Reported Outcome Scores

The lateral opening wedge distal femoral osteotomy (DFO) is an effective treatment for genu valgum to improve mechanical alignment, decrease lateral compartment loads, and decrease the risk of knee osteoarthritis. Multiple studies have utilized outcome scores assessing functional changes related to pain and joint stability, with a focus solely on knee pain and functional outcomes.

The primary aim of this study was to evaluate patient-reported outcome measures (PROMs) that assessed knee function, pain, patient's perception of body image, and limb deformity-related quality of life, both preoperatively and at least 1-year postoperatively.

In a retrospective review of nontraumatic genu valgum patients who underwent bilateral DFO, preoperative and postoperative radiographs were evaluated. Routinely collected preoperative and 1-year postoperative PROMs scores were analyzed, using the Knee Injury and Osteoarthritis Outcome Score Jr. (KOOS-JR) and the Limb Deformity-Modified Scoliosis Research Society (LD-SRS) score, in 72 limbs (36 patients): 7 men (19.44%) and 29 women (80.56%) with an average age of 35.34 ± 13.57 years. The mean follow-up time was 36.85 ± 24.43 months.

Overall mechanical axis deviation, lateral distal femoral angle, and mechanical axis alignment angle were significantly improved after DFO in all patients. Both PROMs also improved significantly from preoperative to postoperative scores: LD-SRS (3.10 ± 0.56 vs 4.19 ± 0.44, respectively) and KOOS-JR (63.02 ± 19.25 vs 78.06 ± 16.29, respectively).

This retrospective review suggests that bilateral lateral opening-wedge DFOs in patients with symptomatic valgus knee deformity may be associated with improved overall knee health, limb deformity-related quality of life, and patients' body image. Further study is needed.