Outcome of dome osteotomy for correction of angular deformity around knee: a case series

Abstract

Angular deformities around the knee, such as genu valgum, genu varum, and recurvatum, can lead to significant functional impairments and pain. Dome osteotomy is a surgical procedure designed to correct these deformities by providing high adjustability, stability, and avoiding limb length discrepancies. This retrospective cohort study involved 20 patients, aged 16 to 23 years, who underwent dome osteotomy for knee deformities between January 1, 2023, and December 31, 2023. The study was conducted at a government tertiary care center and medical college. Preoperative assessments included detailed medical history, physical examination, and radiographic evaluations. The surgical technique involved a cylindrical bone cut centered at the CORA, with postoperative management including immobilization and gradual weight-bearing.The mean preoperative intermalleolar distance (IMD) was 14.52 cm, which improved to 6.85 cm postoperatively (p<0.0001). The clinical tibiofemoral angle improved significantly in both bilateral (from 20.35 degrees to 12.92 degrees, p<0.0001) and unilateral cases (from 18.67 degrees to 8.67 degrees, p<0.004). Patients reported significant pain relief, improved stability, and enhanced mobility during follow-ups. Dome osteotomy is an effective and reliable surgical technique for correcting angular knee deformities. Its high adjustability, stability, and avoidance of limb length discrepancies contribute to significant improvements in clinical and radiological outcomes, enhancing patient quality of life and preventing long-term complications.