Distal Femoral Varus Osteotomy for Lateral Compartment Osteoarthritis in the Valgus Knee. A Systematic Review of the Literature

The primary objectives of this systematic review were to define the indications, functional outcomes, survivorship and complications associated with distal femoral varus osteotomy (DFVO). Cumulative survival with arthroplasty as the endpoint ranged from 64 to 82% at 10 years, and 45% at 15 years. The mean pre-operative HSS score ranged from 46 to 65 and this improved at latest follow up to means of between 72 and 88. Pooled results show an overall complication rate of 5.8% (5/86) for unanticipated re-operation due to a complication. Poor reporting of included studies and considerable heterogeneity between them precluded any statistical analysis. Further study is required to determine the precise indications for DFVO, optimum surgical technique, implant of choice and post-operative rehabilitation regimen as all of these factors may significantly affect the complication profile and outcomes of this procedure. DFVO is technically demanding and requires a significant period of rehabilitation for the patient. However, long-term survivorship and good function have been demonstrated and it remains a potential option for valgus osteoarthritis in carefully selected patients.