Reanalysis of Agelietti Procedure (A Method of Corrective Supracondylar Femoral Osteotomy)

Abstract

Objective: Supracondylar femoral osteotomy is the time tested method, used for correcting the angular (varus & valgus) deformities at the knee. Traditionally, Coventry type of osteotomy where a medial or lateral based wedge of bone is removed or an open wedge osteotomy is made & the space filled with bone graft, is done to achieve the desired correction. This osteotomy is subsequently stabilized with Kirschner wires or plates & screws. Later the limb is externally supported in brace or plaster cast. Here we present a case series of 10 cases, where we have analyzed the efficacy of Aglietti procedure, as a method of femoral supracondylar osteotomy for correcting the valgus deformity at the knee. Methods: Ten valgus adolescent knees were operated in 7 patients by following the Aglietti procedure for correcting the angular deformity at the knee. The results were analyzed taking into consideration the operating time, blood loss during surgery estimated by the number of surgical mops used, stability of the osteotomy in the post-operative period & ultimate range of motion (ROM) obtained at the end of 6 months after the surgery. Results: The average age of patients dealt with was 12.6 years (n=7) with females predominating (n=5) against 2 males. The average time was 47.5 minutes. The average size of the surgical mops used was 15x20 cms. Surgical mops used per patient were 1.6. The average range of flexion achieved at the end of 6 months after surgery was 131.45 degrees ( Rounded average to a measurable value being 131 degrees). Conclusion: In our case series we found Aglietti procedure as an effective method to correct the valgus deformity in adolescent knees. Supracondylar femoral osteotomies are not only for varus an valgus corrections; this osteotomy is used as well for rotation correction and flexion and extension correction, mainly in CP patients. But we used the Agelietti procedure for the correction of angular deformities(varus/valgus) in patients of nutritional rickets. However more number of cases need to be done to make a final conclusion of establishing the superiority of this method over other methods.