Table 1.
Summary of the results described in the literature on medial closing wedge DFVO
| Author | Year | Number | Median Age (range) | Median F-UP | Type of Fixation | Results |
|---|---|---|---|---|---|---|
| McDermott [7••] | 1988 | 22 | Not reported | Not reported | 90° blade plate | 20/22 good results. 1 plate failure and 1 conversion to TKA. Greatest improvement in pain. |
| Healy [39] | 1988 | 23 | 56 years (19–70) | 4 years | 90° blade plate | 93 % were rated as good or excellent (Hospital for Special Surgery Knee Score [HSS]), and 86 % were satisfied with the outcome. |
| Edgerton [36] | 1993 | 23 | Not reported | 8.3 years | 90° blade plate | 71 % rate of satisfactory results |
| Finkelstein [33] | 1996 | 21/24 | 56.3 years (27–77) | 133 months | 90° blade plate | 13 not failed: average improvement in the score of 30 points, greatest improvement in pain. 7 failed osteotomies with subsequent TKA. The survival rate was 83 % (95%CI 65 %–98 %) at 40 months and 64 % (95%CI 48 %–80 %) at the final follow-up. |
| Mathews [41] | 1998 | 21 | Not reported | 1–8 years | 10 knees plaster cast, 5 had 2 staples with a plaster cast, and 6 knees had rigid internal fixation with an AO blade plate. | 33 % of patients had a satisfactory result using the HSS score, and 57 % had a satisfactory result using the Knee Society Clinical Rating. 57 % percent had a significant complication, 19 % knees required TKA. Positive prognostic factors were: grades I to III osteoarthritis, adequate correction of valgus deformity and rigid internal fixation to permit postoperative early mobilization. |
| Stahelin [42] | 2000 | 19 | 56 years (39–71) | 5 years | Malleable semitubular plate | Average HSS score increased: 84 points. 11 knees rated as excellent. 1 implant failure. |
| Aglietti [35] | 2000 | 18 | 54 years (38–75) | 9 years | 90° blade plate | 77 % good or excellent results according to the Knee Society rating system. No patients had nonunion or infection. 1 patient converted to TKA. |
| Marin Morales [37] | 2000 | 17 | 55 years (50–72) | 6.5 years | 95° AO blade-plate and straight blade-plate | 75 % good or excellent results. 1 deep infection. |
| Wang [21] | 2005 | 30 | 53 years (31–64) | 99 months | 90° blade plate | 83 % had a satisfactory result, two had a fair result, and three had conversion to a total knee arthroplasty. The mean knee score improved from 46 points (range, 20–63 points) preoperatively to 88 points (range, 65–99 points) at the time of the most recent follow-up. The survival rate at 10 years was 87 % (95 % CI, 69 %–100 %). |
| Backstein [10] | 2007 | 38 | 44.1 years (20–67) | 123 months | 90° blade plate | Radiographic analysis demonstrated an average tibiofemoral angle 11.68 of valgus preoperatively and 1.28 of varus postoperatively. 60 % had good or excellent results, 7.5 % had a fair result, and 7.5 % had poor results. 230 % converted to TKA. The 10-year survival rate was 82 % (95 % CI, 75 %–89 %), and the 15-year one was 45 % (95 % CI, 33 %–57 %). |
| Omidi-Kashani [34] | 2009 | 25 | 23.3 years (17–41) | 16.3 months | 90° blade plate | The mean knee score improved from 90.7 points (range, 77–96 points) preoperatively to 98.13 points (range, 93–100 points) at the time of the most recent follow-up. |
| Kosashvili [38] | 2010 | 33 | 45.5 years (24–63) | 15.1 years | 90° blade plate | 15 patients converted to TKA, so the failure rate was 48.5 % at 15.6 years. Of the remaining, 58.8 % had good or excellent results. The average age in the failed group was significantly higher than in the non-failed one (47.6 vs. 45.6) |
| Forkel [39] | 2014 | 23 | 47 years (25–55) | 3.5 years | Angle-stable locking plate | All KOOS subitems increased significantly. No significant difference in the subgroup analysis of KOOS subitems for patients with and without microfracture or age (<50 vs. >50 years). 1 case of revision because of nonunion |
Note. F-UP, follow-up; TKA, total knee arthroplasty; CI, confidential interval; KOOS, knee osteoarthritis outcome