Christophe Jacquet1,2, Johanna Chan-Yu-Kin1,2, Akash Sharma1,2, Jean-Noël Argenson1,2, Sébastien Parratte1,2, Matthieu Ollivier3,4. 1. Aix-Marseille Université, CNRS, ISM UMR 7287, 13288, Marseille cedex 09, France. 2. Department of Orthopedics and Traumatology, Institute of Movement and Locomotion, St. Marguerite Hospital, 270 Boulevard Sainte Marguerite BP 29, 13274, Marseille, France. 3. Aix-Marseille Université, CNRS, ISM UMR 7287, 13288, Marseille cedex 09, France. ollivier.matthieu@yahoo.fr. 4. Department of Orthopedics and Traumatology, Institute of Movement and Locomotion, St. Marguerite Hospital, 270 Boulevard Sainte Marguerite BP 29, 13274, Marseille, France. ollivier.matthieu@yahoo.fr.
Abstract
PURPOSE: The distal femoral varization osteotomy (DFVO) by a lateral opening wedge osteotomy is an established intervention for patients suffering from lateral femoro-tibial osteoarthritis on a genu valgum deformity. In order to improve the accuracy of this correction, the use of a customized cutting guide (PSI) has been proposed as an alternative to conventional technique. The objective of our study was to compare the accuracy of post-operative alignment following DFVO in the coronal and sagittal plane using either a conventional abacus technique or PSI guide. METHOD: Twenty-one patients that underwent lateral opening wedge osteotomy from a technique using PSI based on 3D CT-scans were matched 1:1 to 21 patients operated on using a conventional technique (pre-operative planning performed on standard radiographs). The accuracy of the correction was analyzed, comparing coronal and sagittal mechanical post-operative angles with pre-operative planning. RESULTS: With regard to alignment in the coronal plane (HKA correction), our study demonstrated a significant improvement in the accuracy of the correction obtained in the PSI group compared to the conventional group (0.43 ± 0.50 vs 3.95 ± 1.64 p < 0.001). In the sagittal plane (PDFA correction), we also found a significant improvement in correction accuracy in the PSI group (0.52 ± 0.60 vs 3.10 ± 1.83 p < 0.001). There was a significant decrease in operating time (delta 7.7 ± 3.07 (1.5-13.9) (p = 0.0.161) and fluoroscopic images taken (6.9 ± 0.54 (5.8-8) p < 0.001). CONCLUSION: Our results suggest that the use of PSI in DFVO improves the accuracy of correction in both the coronal and sagittal planes compared to conventional techniques.
PURPOSE: The distal femoral varization osteotomy (DFVO) by a lateral opening wedge osteotomy is an established intervention for patients suffering from lateral femoro-tibial osteoarthritis on a genu valgum deformity. In order to improve the accuracy of this correction, the use of a customized cutting guide (PSI) has been proposed as an alternative to conventional technique. The objective of our study was to compare the accuracy of post-operative alignment following DFVO in the coronal and sagittal plane using either a conventional abacus technique or PSI guide. METHOD: Twenty-one patients that underwent lateral opening wedge osteotomy from a technique using PSI based on 3D CT-scans were matched 1:1 to 21 patients operated on using a conventional technique (pre-operative planning performed on standard radiographs). The accuracy of the correction was analyzed, comparing coronal and sagittal mechanical post-operative angles with pre-operative planning. RESULTS: With regard to alignment in the coronal plane (HKA correction), our study demonstrated a significant improvement in the accuracy of the correction obtained in the PSI group compared to the conventional group (0.43 ± 0.50 vs 3.95 ± 1.64 p < 0.001). In the sagittal plane (PDFA correction), we also found a significant improvement in correction accuracy in the PSI group (0.52 ± 0.60 vs 3.10 ± 1.83 p < 0.001). There was a significant decrease in operating time (delta 7.7 ± 3.07 (1.5-13.9) (p = 0.0.161) and fluoroscopic images taken (6.9 ± 0.54 (5.8-8) p < 0.001). CONCLUSION: Our results suggest that the use of PSI in DFVO improves the accuracy of correction in both the coronal and sagittal planes compared to conventional techniques.
Authors: Philip C Noble; Giles R Scuderi; Adam C Brekke; Alla Sikorskii; James B Benjamin; Jess H Lonner; Priya Chadha; Daniel A Daylamani; W Norman Scott; Robert B Bourne Journal: Clin Orthop Relat Res Date: 2012-01 Impact factor: 4.176
Authors: James D Wylie; Daniel L Jones; Melissa K Hartley; Ashley L Kapron; Aaron J Krych; Stephen K Aoki; Travis G Maak Journal: Arthroscopy Date: 2016-06-03 Impact factor: 4.772
Authors: Maximilian Jörgens; Alexander M Keppler; Philipp Ahrens; Wolf Christian Prall; Marcel Bergstraesser; Andreas T Bachmeier; Christian Zeckey; Adrian Cavalcanti Kußmaul; Wolfgang Böcker; Julian Fürmetz Journal: Eur J Trauma Emerg Surg Date: 2022-07-26 Impact factor: 2.374
Authors: Ahmed A-H Abood; Juozas Petruskevicius; Björn Vogt; Adrien Frommer; Robert Rödl; Jan Duedal Rölfing Journal: Strategies Trauma Limb Reconstr Date: 2020 Sep-Dec
Authors: Alexander A Cherny; Anton N Kovalenko; Taras A Kulyaba; Nikolai N Kornilov Journal: Arch Orthop Trauma Surg Date: 2021-07-15 Impact factor: 3.067
Authors: Julian Fürmetz; Sven Patzler; Florian Wolf; Nikolaus Degen; Wolf Christian Prall; Chris Soo; Wolfgang Böcker; Peter Helmut Thaller Journal: BMC Musculoskelet Disord Date: 2020-03-31 Impact factor: 2.362