Medial Biplanar Closing-Wedge Distal Femoral Osteotomy Using an Articulated Tensioning Device for Controlled Osteotomy Closure

Isolated lateral compartment arthritis or focal chondral defects in the setting of genu valgum in young, active individuals can be treated with a varus-producing distal femoral osteotomy with or without cartilage treatment. Both medial closing-wedge and lateral opening-wedge techniques have been described, with neither demonstrating clear superiority. The objective of this Technical Note is to describe a technique of biplanar medial opening-wedge with controlled reduction using an articulated tensioning device to achieve a safe, reproducible result.