Opening wedge distal femoral varus osteotomy using the Puddu plate and calcium phosphate bone cement

The goal of this study was to document the outcome at midterm follow-up of 19 patients treated for lateral osteoarthritis of the knee between 1999 and 2007. It was our hypothesis that the results and complication rate would be comparable to or better than those reported in the literature for closing wedge or alternative open wedge techniques. All patients underwent an open wedge distal femoral varisation osteotomy using the Puddu plate system combined with calcium phosphate injection into the defect. Knee Society Knee Score and Kellgren-Lawrence osteoarthritis score were assessed preoperatively and at final follow-up. The average knee score improved significantly from 43 +/- A 8 preoperatively to 78 +/- A 23 at final follow-up. The Kellgren-Lawrence osteoarthritis score remained unchanged. Kaplan-Meier analysis using revision surgery or conversion to TKA as an endpoint demonstrated an 82 % successful survivorship at 7 years of follow-up. Based upon these results, we believe that a distal femoral varisation osteotomy using the Puddu plate and injectable bone cement is an equivalent treatment option compared to closing wedge techniques and leading to good results at midterm follow-up in patients with lateral gonarthrosis and valgus alignment. IV.