Description
A Distal Femoral Osteotomy (DFO) is a surgical procedure used to treat isolated lateral compartment osteoarthritis in patients who have valgus malalignment (knock-kneed). A distal femoral osteotomy can be used alone as a treatment for lateral compartment osteoarthritis or to correct alignment in conjunction with other cartilage repair procedures. Distal femoral osteotomies are most commonly used to treat arthritis in active patients who are still too young to have a joint replacement or whose activity level is such that they would damage or wear out an artificial joint prematurely. The calculation of the correction uses the angle formed between the mechanical axis of the femur and tibia.
During this osteotomy, a wedge of bone is either added or removed to the femur to realign the knee joint, relieving pain and restoring the balance of the knee.
Opening wedge: incision in the inside of the knee to place a bone graft into the femur. The graft is held in place with a metal plate and screws. Mild to moderate corrections: up to 10°.
Closing wedge: osteotomy involves an incision on the lateral side of the knee and removes a small wedge of the tibia bone before reattaching the two remaining ends with a metal plate and screws. Larger corrections: from 12° to 27°.
Measurements
The measurements made by the procedure are displayed in the image:
- Mechanical Lateral Distal Femoral Angle (mLDFA): the angle between the tangent line to the femoral condyles and the femoral mechanical axis, measured on the lateral side;
- Mechanical Tibiofemoral Angle (mTFA): the angle between the femoral and tibial mechanical axis;
- Joint Line Congruence Angle (JLCA): the angle between the tangent lines of the femoral and tibial condyles;
- Mechanical Medial Proximal Tibial Angle (mMPTA): the angle between the tangent line of the tibial condyles and the tibial mechanical axis, measured on the medial side;
- Weight Bearing Percentage (WBP): percentage where the weight bearing line crosses the tibial plateau line;
- Joint Line Obliquity (JLO): the angle between the tibial plateau line and the horizontal plane of the image.
How to perform
After selecting this procedure in the sidebar, as well as, the side where you will perform the procedure, you must mark the points to conclude it. To see the caption of each point you need to click on this button 
Beware: you can change the position of the points at this stage or later. To do this, simply click on each handle with the left mouse button and move them to the most suitable position.
For advanced configuration, please follow the instructions below.
Advanced Configuration
After the correct positioning of the DFO, it is possible to perform a cut automatically using this option on the Toothed wheel button. After clicking this button, the Auto osteotomy button is available to start configuring the cut. By clicking on the Auto osteotomy button, PeekMed® will automatically perform the correction according to the options selected in this window. The user has the option to perform the osteotomy either from Lateral to Medial direction or Medial to Lateral direction.
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