A recent study published in Knee Surgery, Sports Traumatology, Arthroscopy has provided compelling evidence for the long-term effectiveness of distal femoral osteotomy (DFO) as a joint-preserving procedure. This research followed a cohort of patients for over eight years, demonstrating that DFO is a highly successful treatment for individuals with lateral compartment osteoarthritis of the knee. The findings highlight its ability to relieve pain, restore function, and significantly delay the need for a total knee replacement.
Understanding Distal Femoral Osteotomy
Osteotomy is a surgical procedure that involves cutting and realigning a bone to correct a deformity. In a DFO, the thigh bone (femur) is adjusted to shift the mechanical load from a damaged part of the knee to a healthier area. This procedure is specifically indicated for patients with a valgus deformity, commonly known as ‘knock knees’, where the weight-bearing axis passes through the outer (lateral) compartment of the knee, leading to accelerated wear and tear.
This study’s findings reinforce the core principle of osteotomy: by offloading the affected joint compartment, the procedure can dramatically slow down the degenerative process. This makes DFO an excellent option for younger, active patients who are not yet suitable for a joint replacement, allowing them to maintain their mobility and quality of life for many years.
Key Findings on Long-Term Outcomes
The retrospective cohort study, conducted at a single UK centre, analysed data from 81 patients (86 knees) with an average follow-up period of 99 months. The results were highly encouraging:
- High Survival Rate: The study reported an impressive 10-year survival rate of 89%, with arthroplasty (joint replacement) as the endpoint. This demonstrates the durability and efficacy of DFO as a long-term solution for knee preservation.
- Low Complication Rate: With a low complication rate of just 4.7%, the procedure proved to be a safe and reliable option for patients. This finding is crucial, as it addresses common concerns about surgical risks and patient morbidity.
- Joint Preservation: The research supports the role of DFO in preserving the native knee joint, which allows patients to avoid the more invasive step of a knee replacement. Preserving the natural anatomy offers benefits such as better proprioception and fewer physical restrictions.
While the study noted that the accuracy of correction could still be improved with modern intra-operative techniques, the overall conclusion is clear: DFO is a validated and effective procedure for addressing lateral compartment arthritis. It offers a low-complication, long-term solution for patients with valgus alignment, successfully delaying the need for more extensive joint replacement surgery.
Professor Wilson’s Comments
“I am extremely proud that the research I initiated when I first began my consultant career in Basingstoke has yielded such meaningful results in both the fields of osteotomy surgery and ligament reconstruction. Through securing over £500,000 in research grants, I was able to establish a dedicated research team at Basingstoke. Together with our fellows and clinical team, we investigated our innovative ligament reconstruction techniques and osteotomy procedures in depth.
This body of work generated the largest published series of femoral osteotomy cases as well as the largest series of high tibial osteotomy surgeries. In this paper, we present the 10-year outcomes from our femoral osteotomy cohort, which included nearly 100 patients. The results demonstrate excellent survivorship at 10 years, underscoring the durability and success of our surgical techniques.”
For an in-depth look at the full data and a comprehensive breakdown of the methodology, refer to the complete research paper:
Sources used in report overview:
- https://pubmed.ncbi.nlm.nih.gov/32285155/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC4900333/
- https://www.briangilmermd.com/distal-femoral-osteotomy-knee-sports-medicine-specialist-reno-nv/
