A Novel Technique of Femoral Supracondylar Focal Dome Osteotomy for Correction of Frontal Plane Knee Deformities in Children and Young Adults.

Introduction: Frontal plane knee deformities in adolescents and young adults often require corrective osteotomy to realign the mechanical axis. Numerous methods have been described in the literature, but the method of choice continues to be debatable. The purpose of our study was to evaluate outcomes with a novel technique of focal dome osteotomy (FDO).

Methods: Our prospective study included 20 adolescents/young adults with lower limb deformities eligible for corrective surgical procedures. These patients underwent an FDO, post which they were evaluated clinically, radiologically, functionally, and cosmetically.

Results: 21 distal femur FDOs were performed in 20 patients with frontal plane knee deformities. Clinically, the tibiofemoral angle and the Q angle were restored to normal post-surgery. Radiological evaluation showed a statistical difference in immediate postoperative values of mechanical lateral distal femoral angle (mLDFA) and radiological anatomic tibiofemoral angle (TFA), with restoration to the normal range. Hospital for Special Surgery (HSS) scoring for functional outcome showed significant improvement with an excellent score of 86.47 at the 1-year follow-up. Range of motion was restored to normal at the 2-month follow-up. Cosmetic visual analog score (VAS) and Patient Satisfaction Scores showed good outcomes, too.

Conclusion: FDO is an effective treatment for frontal plane knee deformities mandating a surgical procedure, in children and young adults. It helps to correct deformity without limb length discrepancies. The novel surgical technique ensured good clinical, radiological, and functional outcomes, along with the advantage of cosmetic superiority over other techniques.

Supplementary information: The online version contains supplementary material available at 10.1007/s43465-025-01388-4.