1. Rotation osteotomy of the distal femur influences coronal femoral alignment and the ischiofemoral space
- Author
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Ulrich Stöckle, Marc-Daniel Ahrend, Sufian S. Ahmad, Myriam Ruth Beyer, and Christian Konrads
- Subjects
medicine.medical_specialty ,Knee Joint ,medicine.medical_treatment ,Radiography ,Osteotomy ,Rotation ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,Orthopedics and Sports Medicine ,Femur ,Femoral neck ,Orthodontics ,030222 orthopedics ,Tibia ,Femur Neck ,business.industry ,030229 sport sciences ,General Medicine ,medicine.anatomical_structure ,Lower Extremity ,Coronal plane ,Orthopedic surgery ,Surgery ,business - Abstract
Introduction Despite the fact that osteotomies around the knee represent well-established treatment options for the redistribution of loads and forces within and around the knee joint, unforeseen effects of these osteotomies on the remaining planes and adjacent joints are still to be defined. It was, therefore, the aim of this study to determine the influence of a distal femoral rotation osteotomy on the coronal limb alignment and on the ischiofemoral space of the hip joint. Materials and methods Long-leg standing radiographs and CT-based torsional measurements of 27 patients undergoing supracondylar rotational osteotomies of the femur between 2012 and 2019 were obtained and utilized for the purpose of this study. Postoperative radiographs were obtained after union at the osteotomy site. The hip–knee–ankle angle (HKA), the mechanical lateral distal femur angle (mLDFA), and the ischiofemoral space were measured. Comparison between means was performed using the Wilcoxon–Mann–Whitney test. Results Twenty-seven patients underwent isolated supracondylar external rotation osteotomy to reduce the overall antetorsion of the femur. The osteotomy resulted in a 2.4° ± 1.4° mean increase in HKA and 2.4 mm ± 1.7 mm increase in the ischiofemoral space (p Conclusion Supracondylar external rotation osteotomy of the femur leads to valgisation of the coronal limb alignment and increases the ischiofemoral space. This is resultant to the reorientation of the femoral antecurvature and the femoral neck. When planning a rotational osteotomy of the lower limb, this should be appreciated and may also aid in the decision regarding osteotomy site.
- Published
- 2020