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Technique for Lateral Opening Wedge Distal Femoral Osteotomy Using Patient-Specific Instrumentation for Genu Valgum
Alexander P Decilveo1, Elan Karlin2, Neil Patel3
1Department of Orthopaedic Surgery Southern California Permanente Medical Group Los Angeles California U.S.A.
Arthroscopy Techniques
|July 25, 2026
Summary
Recurrent lateral patellar instability is challenging. Combining distal femoral osteotomy with soft-tissue repair improves outcomes by correcting bone alignment and reinforcing knee stability.
Area of Science:
- Orthopaedic Surgery
- Biomechanics
- Knee Joint Anatomy
Background:
- Recurrent lateral patellar instability presents significant surgical challenges.
- Isolated soft-tissue repairs (MPFL reconstruction, lateral release) have high failure rates.
- Underlying bony malalignment contributes to patellar instability.
Purpose of the Study:
- To evaluate the efficacy of lateral opening wedge distal femoral osteotomy combined with soft-tissue procedures for treating recurrent lateral patellar instability.
- To assess the role of patient-specific instrumentation in improving osteotomy accuracy and safety.
Main Methods:
- Surgical technique involving lateral opening wedge distal femoral osteotomy.
- Concurrent soft-tissue reconstruction or augmentation.
- Utilization of patient-specific instrumentation for osteotomy planning and execution.
Main Results:
- Distal femoral osteotomy addresses bony malalignment, a key factor in instability.
- Combined approach reinforces the patellofemoral joint, potentially reducing failure rates.
- Patient-specific instrumentation enhances surgical accuracy and minimizes intraoperative complications like hinge fractures.
Conclusions:
- Lateral opening wedge distal femoral osteotomy is a viable option for recurrent lateral patellar instability when bony malalignment is present.
- The combination with soft-tissue procedures offers a more robust solution than soft-tissue procedures alone.
- Patient-specific instrumentation improves the precision and safety of this complex osteotomy.
