Comparison of medial and lateral approaches in distal femoral varus osteotomy to correct genu valgum

Background: Genu valgum deformity is defined as lateral displacement of lower extremity mechanical axis in knee joint. This can be corrected by medial or lateral distal femoral approach. In this study the effectiveness of distal femoral osteotomy in medial and lateral approach is evaluated by the Knee Society Score and alterations in mechanical axis before and after osteotomy. Methods: This is a descriptive cross-sectional study on 27 patients referred to Shafa Orthopedic Hospital for corrective osteotomy by “medial close wedge” and “lateral open wedge” during 2005-2011. Data were collected from patient file, questionnaire, radiographs and physical examination. Results: We evaluated 30 knee joints in 27 patients. Genu valgum was right-sided in 10 cases (37%), left-sided in 14 patients (52%) and bilateral in 3 cases (11%). The mean follow up was 30.7 ± 3.3 (range: 5-76) months. Patients were between 10-34 years. Osteotomy was medial in 11 and lateral in 19 cases. Postoperative tibiofemoral angle was significantly different from preoperative value. Difference in tibiofemoral angle change was not significant between medial and lateral approaches. Knee Society Score in two groups was also insignificant. Conclusion: There was no significant difference in lower extremity mechanical axis change after genu valgum correction surgery between medial or lateral approaches.