Opening-Wedge Distal Femoral Osteotomy With Concomitant Medial Meniscal Root Repair

Area of Science:

• Orthopedic Surgery
• Biomechanical Engineering
• Sports Medicine

Background:

• Valgus malalignment increases lateral knee compartment loading, contributing to meniscal injuries and osteoarthritis.
• Distal femoral osteotomy (DFO) corrects alignment to offload the lateral compartment.
• Concurrent medial meniscal root repair addresses medial compartment pathology.

Purpose of the Study:

• To describe a surgical technique for valgus deformity correction using opening-wedge DFO and concurrent medial meniscal root repair.
• To restore native knee alignment and load distribution.
• To improve medial meniscus function for axial force dispersion.

Main Methods:

• Preoperative planning with long-leg alignment radiographs and MRI.
• Lateral opening-wedge DFO with internal fixation.
• Arthroscopic medial meniscal root repair.
• Specific surgical sequence: lateral approach, arthroscopy, meniscal repair, osteotomy, fixation.

Main Results:

• Literature shows heterogeneous outcomes for DFO, with reported success rates of 64-85% for varus-producing DFO at 10 years.
• Studies indicate significant improvements in knee function and pain scores post-DFO.
• The described technique aims to restore joint axis and meniscal function.

Conclusions:

• The described surgical technique effectively corrects valgus deformity.
• Concurrent DFO and medial meniscal root repair restores knee biomechanics and meniscal function.
• This combined approach can delay or prevent progression of knee osteoarthritis.