Distal femoral varus osteotomy for painful genu valgum. A five-to-11-year follow-up study.

From 1978 until 1984, 23 patients (24 knees) were treated with varus producing distal femoral osteotomy for painful, lateral compartment osteoarthrosis. Evaluation at five to 11 years (average, 8.3 years) included orthopedic examination, calculation of the Hospital for Special Surgery (HSS) knee score, and standing knee roentgenograms. Based on the objective knee scores, 71% of the patients had good or excellent results, with no difference in those followed for longer periods. Complications occurred in 63% of the cases, including nonunion (25%) and loss of correction (21%). Both complications were associated exclusively with staple fixation, which was performed during the period of this study and is now known to be inadequate to fix this osteotomy. Despite increasing morbidity rates, these complications did not appear to influence the ultimate result. A statistically significant prognostic factor was the severity of the disease as reflected by the pre- and postoperative knee scores. Further, the degree of correction was a function of the initial deformity. At follow-up evaluation 13% of the knees had been converted to a total knee replacement.