Distal femoral varus osteotomy in the valgus osteoarthritic knee.

The results of 18 distal femoral varus osteotomies performed in 18 patients between 1982 and 1993 were evaluated. All patients had degenerative arthritis of the lateral compartment of the knee associated with a valgus deformity. At surgery, the average patient age was 54 years (range: 38-75 years). The average follow-up was 9 years (range: 5-16 years). The average tibiofemoral angle was 17.5 degrees of valgus preoperatively and 6 degrees postoperatively. Seventeen patients (1 patient died from an unrelated cause) were evaluated at follow-up according to the Knee Society rating system. At follow-up, 13 (77%) were rated as good or excellent by the Knee Society rating system. The Knee score improved from 54 points preoperatively to 89 points postoperatively. The functional score improved from 65 points preoperatively to 86 points postoperatively. One knee required a subsequent total knee arthroplasty (TKA) 5 years after osteotomy due to severe and persistent pain. No patient had infection or nonunion. Varus osteotomy of the distal femur is a reliable and effective surgical procedure for the treatment of gonarthrosis associated with valgus deformity in both young and older active patients, where it can be an alternative to TKA.