The effect of lateral opening wedge distal femoral osteotomy on medial knee opening: Clinical and biomechanical factors

Iftach Hetsroni, Stephen Lyman, Andrew D. Pearle, Robert G. Marx

研究成果: Contribution to journalArticle査読

21 被引用数 (Scopus)

抄録

Purpose: The case of a patient with knee valgus and instability due to combined ACL-MCL laxity who underwent lateral opening wedge distal femoral osteotomy (DFO) is presented. The symptoms of instability resolved following the surgery. It was unclear whether the increase in valgus stability was related only to a decrease in valgus moments during stance or also to a medial tensioning effect. We therefore performed a laboratory cadaveric study. The purpose of this study was to examine whether after MCL and ACL sectioning, lateral opening wedge DFO would result in decrease in medial opening under static conditions of valgus stress. Methods: Medial knee opening under valgus load of 9.8 Nm was tested in 8 cadaveric specimens in scenarios of MCL and ACL sectioning and compared before and after performing lateral opening wedge DFO. Results: When the superficial MCL was sectioned, medial knee opening in 30° flexion decreased after lateral opening wedge DFO compared to medial opening before the osteotomy (i.e. from 6.5 ± 0.5° to 5.6 ± 0.5°, p = 0.01). When the superficial MCL, deep MCL, and ACL were all sectioned, medial knee opening in extension decreased after lateral opening wedge DFO compared to medial opening before the osteotomy but this was not significant (i.e. from 6.8 ± 0.5° to 6.1 ± 0.5°, p = n.s.). Conclusion: In superficial MCL-transected knees, medial laxity at 30° of knee flexion decreased after lateral opening wedge DFO. However, the clinical relevance of the laxity decrease observed remains uncertain since the reduction was small in magnitude. Level of evidence: Controlled laboratory study.

本文言語英語
ページ(範囲)1659-1665
ページ数7
ジャーナルKnee Surgery, Sports Traumatology, Arthroscopy
22
7
DOI
出版ステータス出版済み - 7 2014
外部発表はい

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

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