Summary: The morphological analysis of distal femurs using computed tomography images showed that the medial cortical angle and height was shallower and lower than those of the lateral cortex at the osteotomy site, particularly in patients with valgus knee. Therefore, surgeons should be cautious when creating anterior flange during medial closing wedge distal femoral osteotomy for valgus knees.

Introduction:Distal femoral osteotomy (DFO) has been performed to treat patients with knee OA. Although bi-plane technique has become popular in DFO, it is technically demanding, especially in creation of the anterior flange. To create anterior flange properly, direction of cutting and thickness of the anterior flange appear to be important. However, morphological characteristics of distal femurs considering surgical reference for DFO have never been reported. The purpose of this to examine morphological characteristic of distal femur based on the cortical shape for surgical reference in DFO.
Methods:Computed tomography images of 50 valgus knees in 49 patients and 50 varus knees in 48 patients who underwent DFO or total knee arthroplasty were analyzed. The axial slice 65 mm proximal to the joint line, which corresponds to the average starting level of the transverse osteotomy in DFO previously performed in our hospital, was chosen. First, a tangential line to the outside of the posterior cortex was drawn (Line 1). Second, a tangential line to the anterior cortex and parallel to the line 1 was drawn (Line 2). Third, tangential lines to the medial cortex (Line 3) and to the lateral cortex (Line 4) were drawn. The angle between Line 1 and Line 3 was defined as the medial cortex line angle (MCLA) and between Line 1 and Line 4 as the lateral cortex line angle (LCLA). The height of the medial and lateral side was measured as follow. The tangential lines to the inside of the posterior cortex line (Line 6) and the anterior cortex (Line 7) were drawn. The inner crossing points of the Line 7 at the medial side (point M) and the lateral side (point L) were determined. The vertical distance between Line 6 and Point M was defined as the medial cortex height (MCH) and between Line 7 and Point L was defined as the lateral cortex height (LCH). Statistical comparisons were formed between medial and lateral, and between valgus and varus knees.
Results:In valgus knees, the mean MCLA and LCLA were 68.1 ± 8.5° and 78.4 ± 4.3°, and MCH and LCH were 21.3 ± 3.5 mm and 27.3 ± 3.8 mm respectively. In varus knees, the mean MCLA and LCLA were 74.8 ± 5.9° and 80.4 ± 4.7°, and MCH and LCH were 24.7 ± 3.1 mm and 30.3 ± 3.3 mm respectively. The mean MCLA was significantly smaller than LCLA, and the mean MCH was lower than LCH in both valgus and varus knees (All, P < 0.01). The mean MCLA and LCLA in valgus knees were smaller than those in varus knees, and the mean MCH and LCH in valgus knees were lower than those in varus knees (All, P < 0.02).
Discussion:The medial cortical angle and height was shallower and lower than those of the lateral cortex at the osteotomy site, particularly in patients with valgus knee. Therefore, surgeons should be cautious when creating anterior flange during medial closing wedge DFO to avoid creating too thick anterior flange.

MRI Findings of Medial Collateral Ligament Complex In Early Osteoarthritis of the Knee ePoster Presentation Hiroaki Tsukamoto, MD,PhD, JAPAN Hidetomo Saito, MD, PhD, JAPAN Manabu Akagawa, MD, PhD, JAPAN Naohisa Miyakoshi, MD, PhD, JAPAN
Morphologic Feature of the Proximal Tibia In Middle-Aged Women with Early Knee Osteoarthritis from Iwaki Cohort Study ePoster Presentation Hikaru Kristi Ishibashi, MD, JAPAN Eiji Sasaki, MD, PhD, JAPAN Takahiro Tsushima, MD, PhD, JAPAN Yuka Kimura, MD, PhD, JAPAN Yasuyuki Ishibashi, MD, JAPAN Daisuke Chiba, MD, PhD, JAPAN Yuji Yamamoto, MD, JAPAN
The Effectiveness of Computed Tomography in Lateral Hinge Fracture in Medial Opening Wedge High Tibial Osteotomy ePoster Presentation Masataka Ota, MD, JAPAN Atsushi Sato, MD, PhD, JAPAN Jun Oike, MD, PhD, JAPAN Kanako Izukashi, MD, JAPAN Takayuki Okumo, MD, PhD, JAPAN Naoki Okuma, MD, JAPAN Takayuki Koya, MD, PhD, JAPAN Fumiyoshi Kawashima, MD, JAPAN Hiroshi Takagi, MD, PhD, JAPAN Koji Kanzaki, Prof., JAPAN
A Finite Element Analysis of Appropriate Hinge Position in Medial Closing Wedge Distal Femoral Osteotomy to Prevent Hinge Fracture ePoster Presentation Atsuki Tanaka, MD, JAPAN Takehiko Matsushita, MD, PhD, JAPAN Tatsuya Nakatsuji, PhD, JAPAN Yosuke Katsui, BE, JAPAN Kanto Nagai, MD, PhD, JAPAN Toshiji Mukai, PhD, Prof, JAPAN Ryosuke Kuroda, MD, PhD, JAPAN
Pre and Postoperative Changes in Alignment of the Ankle and Subtalar Joint in Patients Undergoing High Tibial Osteotomy for Knee Osteoarthritis ePoster Presentation Yuki Nishimura, MD, JAPAN Munehiro Ogawa, MD, PhD, JAPAN Kensuke Okamura, MD, JAPAN Yusuke Inagaki, MD, PhD, JAPAN Yasuhito Tanaka, Prof., JAPAN
Cementless Metal-Backed Patella: Back For Good? Excellent Short-Term Survivorship - No Loosening On 2 To 5 Years Follow Up. ePoster Presentation Fransiska Dhyana Guerreiro , MBBS, MSc, MRCS, UNITED KINGDOM Niall Alastair Kenneth Flynn, MB ChB, FRCS, FRCS(Tr & Orth), UNITED KINGDOM
Medial Closed-Wedge Distal Femoral Varus Osteotomy Improves Patellofemoral Joint Congruity ePoster Presentation Masanari Hamasaki, MD,PhD, JAPAN Eiji Kondo, MD, PhD, JAPAN Koji Yabuuchi, MD, JAPAN Koji Iwasaki, MD, PhD, JAPAN Yuki Suzuki, MD, PhD, JAPAN Masatake Matsuoka, PhD, JAPAN Tomohiro Onodera, MD, PhD, JAPAN Kazunori Yasuda, MD, PhD, Prof., JAPAN Tomonori Yagi, MD, PhD, JAPAN Norimasa Iwasaki, MD, PhD, JAPAN
Medial Meniscal Extrusion is Significantly Increased in Meniscal Root Tears and Associated with Increased Incidence of Knee Osteoarthritis: A Systematic Review with Meta-Analysis ePoster Presentation Francis Fong, SINGAPORE Bryan Wei Loong Ong, MBBS, SINGAPORE Yee-Han Dave Lee, MBBS, FRCS(Ortho), SINGAPORE
Techniques and Objective Outcomes in the Surgical Treatment of Chronic Posterolateral Corner Knee Injuries: An Updated Systematic Review Reflecting the 2019 Expert Consensus Statement ePoster Presentation Garrett Jackson, MD, UNITED STATES Harkirat Jawanda, BS, UNITED STATES Enzo Salviato Mameri, MD, MSc, BRAZIL Anjay Batra, BS, UNITED STATES Derrick Michael Knapik, MD, UNITED STATES Robert F. LaPrade, MD, PhD, UNITED STATES Nikhil N. Verma, MD, UNITED STATES Jorge Chahla, MD, PhD, UNITED STATES
Evaluation of Genetic Markers In Athletes And Patients With Cartilage Injury and Osteoarthritis Non-Responsive For Conservative Treatment – Methods Description ePoster Presentation Joao Vitor De Castro Fernandes, MD, MSc, BRAZIL Sergio Ferreira Barbosa Junior, MD, BRAZIL Ricardo di Lazzaro Filho, MD, MsC, BRAZIL Riccardo Gomes Gobbi, MD, PhD, BRAZIL Arnaldo J. Hernandez, MD, PhD, BRAZIL Marcia Uchoa De Rezende, MD, BRAZIL Tiago Lazzaretti Fernandes, MD, PhD, MSc, Post-Doctorate, BRAZIL
Alteration of Stress Distribution Patterns Across the Patellofemoral Joint After Neutral Wedge High Tibial Osteotomy: An Evaluation Using Computed Tomography Osteoabsorptiometry ePoster Presentation Yoshio Nishida, MD, JAPAN Koji Iwasaki, MD, PhD, JAPAN Masatake Matsuoka, PhD, JAPAN Tomohiro Onodera, MD, PhD, JAPAN Eiji Kondo, MD, PhD, JAPAN Norimasa Iwasaki, MD, PhD, JAPAN
Open-Wedge High Tibial Osteotomy with a Slight Valgus Correction From Neutral Limb Alignment Achieves Clinical Improvements Comparable with Those for Knees with Varus Deformity ePoster Presentation Junya Itou, MD, PhD, JAPAN Umit Kuwa, MD, PhD, JAPAN Masafumi Itoh, MD, PhD, JAPAN Takehiro Shimizu, MD, JAPAN Ken Okazaki, MD, PhD, JAPAN
Varus Alignment Was a Risk Factor For Osteoarthritis of the Knee After the Anterior Cruciate Ligament Injury: A Systematic Review and Meta-Analysis ePoster Presentation Junya Itou, MD, PhD, JAPAN Masafumi Itoh, MD, PhD, JAPAN Umit Kuwa, MD, PhD, JAPAN Ken Okazaki, MD, PhD, JAPAN Kiyotaka Iwasaki, Prof, JAPAN
A New High-Flexion Design Total Knee Prosthesis: A Nine To Eleven-Year Follow-Up Study ePoster Presentation Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Dongho Kwak, MD, KOREA, REPUBLIC OF Sungcheol Yang, MD, KOREA, REPUBLIC OF Hyukjin Jang, MD, KOREA, REPUBLIC OF Ryu Kyoung Cho, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF
Assessing The Relationship Between Knee Joint Biomechanics and Trunk Posture According To Osteoarthritis Severity ePoster Presentation Yuki Suzuki, MD, PhD, JAPAN Yasumitsu Ohkoshi, MD, JAPAN Kensaku Kawakami, Ph.D., JAPAN Kenta Shimizu, P.T., JAPAN Shuya Chida, P.T., JAPAN Kengo Ukishiro, PT, MS, JAPAN Tomohiro Onodera, MD, PhD, JAPAN Koji Iwasaki, MD, PhD, JAPAN Tatsunori Maeda, MD, JAPAN Shoji Suzuki, M.eng, JAPAN Eiji Kondo, MD, PhD, JAPAN Norimasa Iwasaki, MD, PhD, JAPAN
Extent of Preoperative Medial Meniscal Extrusion Influences Intermediate-Term Outcomes after Medial Opening-Wedge High Tibial Osteotomy ePoster Presentation Hong Yeol Yang, MD, PhD, KOREA, REPUBLIC OF Jong-Keun Seon, MD, PhD, Prof, KOREA, REPUBLIC OF
Plantar Pressure Pattern During Walking In Patient With Medial Knee Osteoarthritis ePoster Presentation Kyohei Nishida , MD, PhD, JAPAN Kanto Nagai, MD, PhD, JAPAN Noriyuki Kanzaki, MD, PhD, JAPAN Yuichi Hoshino, MD, PhD, JAPAN Takehiko Matsushita, MD, PhD, JAPAN Ryosuke Kuroda, MD, PhD, JAPAN
Advanced Therapy with Mesenchimal Stromal Cell for Knee Osteoarthritis or Chondral Lesions: A Systematic Review ePoster Presentation Caio Gomes Tabet, MD, BRAZIL Rafael Pacheco, MD, BRAZIL Ana Luiza Cabrera Martimbianco, BRAZIL Daniela Franco Bueno, DDS, PhD, BRAZIL Rachel Riera, Prof., BRAZIL Arnaldo J. Hernandez, MD, PhD, BRAZIL Tiago Lazzaretti Fernandes, MD, PhD, MSc, Post-Doctorate, BRAZIL
Lowered Patella and Higher Age the Relevant Predictors of Patellofemoral Osteoarthritis after Anterior Cruciate Ligament Reconstruction of the Knee ePoster Presentation Takayuki Okumo, MD, PhD, JAPAN Atsushi Sato, MD, PhD, JAPAN Masataka Ota, MD, JAPAN Kanako Izukashi, MD, JAPAN Jun Oike, MD, PhD, JAPAN Saki Yagura, MD, JAPAN Naoki Okuma, MD, JAPAN Takayuki Koya, MD, PhD, JAPAN Fumiyoshi Kawashima, MD, JAPAN Hiroshi Takagi, MD, PhD, JAPAN Koji Kanzaki, Prof., JAPAN
Factors of Patella Height in the Open Wedge High Tibial Osteotomy Patients ePoster Presentation Takashi Hoshino, MD, PhD, JAPAN Hiroki Katagiri, MD, PhD, JAPAN Tomomasa Nakamura, MD, PhD, JAPAN Nobutake Ozeki, JAPAN Yusuke Nakagawa, JAPAN Mai Katakura, MD, PhD, JAPAN Masaki Amemiya, MD, PhD, JAPAN Aritoshi Yoshihara, MD, JAPAN Kazuyoshi Yagishita, MD, PhD, JAPAN Ichiro Sekiya, MD, PhD, JAPAN Hideyuki Koga, Prof., MD, PhD, JAPAN
Osteoarthritis Causes Quadriceps and Hamstring Dynapenia as Measured with DINABANG ePoster Presentation Dario Santos, PhD, URUGUAY Juan Miguel Del Castillo, MD, URUGUAY Rene Ledezma, M Sc, URUGUAY Andrea Mattiozzi, MD, MSc, URUGUAY Rodrigo Barboza, Engr., URUGUAY Jorge Dominguez, Engr., URUGUAY Cristina Touriño, MD; PhD, URUGUAY Franco Simini, Prof., URUGUAY
One-Leg Flexion View For The Tibiofemoral Joint Space Assessment ePoster Presentation Danaithep Limskul, MD, THAILAND Maruay Tanayavong, MD, THAILAND Srihatach Ngarmukos, MD, THAILAND Aree Tanavalee, MD, THAILAND Thanathep Tanpowpong, MD, THAILAND
Appropriate Patient Selection Based on Joint Line Convergence Angle Minimizes Difference in Mechanical Axis between Standing and Supine Positions after High Tibial Osteotomy ePoster Presentation Naosuke Nagata, MD, JAPAN Takehiko Matsushita, MD, PhD, JAPAN Kyohei Nishida , MD, PhD, JAPAN Kanto Nagai, MD, PhD, JAPAN Noriyuki Kanzaki, MD, PhD, JAPAN Yuichi Hoshino, MD, PhD, JAPAN Ryosuke Kuroda, MD, PhD, JAPAN
No Significant Difference in Signs of Osteoarthritis after Anterior Cruciate Ligament Injuries Comparing Surgical and Conservative Treatment ePoster Presentation Miklos Mate, MD, HUNGARY Robert de Jonge, MD, HUNGARY Gergely Pánics, PhD, HUNGARY
Accurate Alignment Correction and Satisfactory Clinical Outcomes After Personalised Valgus High Tibial Osteotomy With A New Patient-Specific Instrumentation: A First In Man Study ePoster Presentation Stefano Zaffagnini, MD, Prof., ITALY Giacomo Dal Fabbro, MD, AUSTRALIA Alberto Grassi, PhD, ITALY Alisdair MacLeod, UNITED KINGDOM Claudio Belvedere, PhD, ITALY Alberto Leardini, DPhil, ITALY
Surgically Modifiable Skeletal and Soft Tissue Variables and the Medial Pivot of the Knee ePoster Presentation Peter James McEwen, MBBS FRACS(Orth) FAOrthA DIpModLang , AUSTRALIA
Developing an Experimental Model of Early Knee Osteoarthritis after Medial Meniscus Posterior Root Release: An In Vivo Study ePoster Presentation Lika Dzidzishvili, MD, PhD, SPAIN Irene Isabel López-Torres, MD, PhD, SPAIN Emilio Calvo, MD, PhD, MBA, SPAIN
The Effect Of Medial Closing Wedge Distal Femoral Varus Osteotomy On Contact Stress Distribution Pattern Of The Femorotibial Joint ePoster Presentation Masanari Hamasaki, MD,PhD, JAPAN Eiji Kondo, MD, PhD, JAPAN Koji Yabuuchi, MD, JAPAN Koji Iwasaki, MD, PhD, JAPAN Yuki Suzuki, MD, PhD, JAPAN Masatake Matsuoka, PhD, JAPAN Tomohiro Onodera, MD, PhD, JAPAN Kazunori Yasuda, MD, PhD, Prof., JAPAN Tomonori Yagi, MD, PhD, JAPAN Norimasa Iwasaki, MD, PhD, JAPAN
Digital Planning Using Medial Proximal Tibial Angle and 3D-Printed Patient-Specific Instrument in Medial Opening Wedge High Tibial Osteotomy Could Provide an Accurate and Reliable Correction for Medial Knee Osteoarthritis ePoster Presentation Jia-Lin Wu, MD, MS, TAIWAN Kuang-Yuan Goh, MD, TAIWAN Shih-Han Lee, MD, TAIWAN Shen-Han Wu, MD, TAIWAN
Serial Assessment Of Bone Healing After Medial Opening Wedge High Tibial Osteotomy Without Bone Graft ePoster Presentation Siyoung Song, MD, PhD, KOREA, REPUBLIC OF Sung Yup Hong, MD, KOREA, REPUBLIC OF Hyobeom Lee, MD, KOREA, REPUBLIC OF
Investigation Of The Relationship Between Responder Rate To Leucocyte-Poor Platelet Rich Plasma (LP-PRP) Therapy and %mechanical axis (%Ma) In Patients With Medial Type Knee Osteoarthritis (KOA) ePoster Presentation Ryosuke Nakajima, MD, JAPAN Yoshitomo Saita, MD, PhD, JAPAN Sayuri Uchino, MD, PhD, JAPAN Yasumasa Momoi , MD, JAPAN Nanako Yamamoto, MD, JAPAN Haruka Kaneko, JAPAN Mitsuaki Kubota, MD, PhD, JAPAN Muneaki Ishijima, MD, PhD, JAPAN
Mechanical Axis Changes and its Related Factors on the Whole Leg Preoperative Planning X-Rays under Bilateral and Unilateral Weight Bearing in HTO Patients ePoster Presentation Tomomasa Nakamura, MD, PhD, JAPAN Takashi Hoshino, MD, PhD, JAPAN Hiroki Katagiri, MD, PhD, JAPAN Aritoshi Yoshihara, MD, JAPAN Masaki Amemiya, MD, PhD, JAPAN Yusuke Nakagawa, JAPAN Nobutake Ozeki, JAPAN Hideyuki Koga, Prof., MD, PhD, JAPAN
Short-Term Outcomes Of Dome-Shaped High Tibial Osteotomy Combined With All-inside Anterior Cruciate Ligament Reconstruction ePoster Presentation Toshiaki Takahashi, MD, PhD, Prof., JAPAN Seiji Watanabe, MD, JAPAN
Subsequent Surgeries Following Osteochondral Allograft and Osteochondral Autograft at up to Ten Years: An Analysis of over 2,000 Patients ePoster Presentation Patrick J Burroughs, MD, UNITED STATES Joseph B Kahan, MD, UNITED STATES Jay Moran, BS, UNITED STATES Stephen M Gillinov, AB, UNITED STATES Peter Y Joo, MD, MPH, UNITED STATES Christopher Schneble, MD, UNITED STATES Harold Gregory Moore, MD, UNITED STATES Jonathan Grauer, UNITED STATES Michael J. Medvecky, MD, UNITED STATES
Analysis Of The Effect Of Osteoporosis On Varus Alignment Of End Stage Knee Osteoarthritis ePoster Presentation Seung Hoon Lee, MD, KOREA, REPUBLIC OF Jung Ro Yoon, MD, KOREA, REPUBLIC OF Tae Hyuk Yoon, MD, KOREA, REPUBLIC OF Young Bin Shin, MD, KOREA, REPUBLIC OF

Menu

Search Filters

Morphological Analyses of Distal Femur For Surgical Reference in Bi-Plane Distal Femoral Osteotomy

Morphological Analyses of Distal Femur For Surgical Reference in Bi-Plane Distal Femoral Osteotomy

More 2023 Congress Knee Osteoarthritis ePosters

More 2023 ISAKOS Congress Content

Menu

Search Filters

Sign-in to ISAKOS

Morphological Analyses of Distal Femur For Surgical Reference in Bi-Plane Distal Femoral Osteotomy

Morphological Analyses of Distal Femur For Surgical Reference in Bi-Plane Distal Femoral Osteotomy

More 2023 ISAKOS Congress Content