Distal Femoral Osteotomy (DFO) – A Joint-Preserving Solution for Knock-Knee Arthritis By Dr. Kashyap Solanki – Orthopaedic & Joint Preservation Surgeon, Mumbai

What Is a Distal Femoral Osteotomy?

A Distal Femoral Osteotomy (DFO) is a bone-realignment surgery performed on the lower end of the thigh bone (femur) to correct knock-knees (valgus knee deformity).

In many young and active patients, arthritis develops only on the outer (lateral) side of the knee due to this alignment problem.

Instead of replacing the joint, DFO shifts weight to the healthier inner side, helping relieve pain and preserve the natural knee.

Goal: Delay or avoid Total Knee Replacement and maintain an active lifestyle.

Who Needs DFO?

This surgery is ideal for:

✅ Young or middle-aged patients (often women <50 years)

✅ Knock-knee alignment causing pain on the outer side of the knee

✅ Early-to-moderate lateral compartment arthritis

✅ Good knee movement and stable ligaments

✅ Active lifestyle (walking, jogging, sports)

Not suitable for:

❌ Advanced arthritis in all compartments

❌ Severe stiffness or instability

❌ Poor bone quality or inflammatory arthritis flare phase

Why Not Directly Do a Knee Replacement?

In younger patients, knee replacement is not always the first choice. DFO preserves the natural joint, allows high-activity levels, and postpones knee replacement by 8–12 years when done in the right candidate.

Think of DFO as “correcting the root cause instead of replacing the joint.”

How the Surgery Works

• A small incision is made on the lower thigh

• Bone is carefully cut (osteotomy)

• The limb alignment is corrected to shift weight to the healthy cartilage side

• Bone is fixed with a plate & screws

• Bone heals and remodels over time in the corrected position

Modern techniques allow precise angle correction using X-ray/CT-based planning and digital tools.

Recovery Timeline

Stage	Timeline
Hospital Stay	2–3 days
Partial Weight-Bearing	2–3 weeks
Full Weight-Bearing	6–8 weeks
Return to Routine	8–12 weeks
Full Healing	~4–6 months

Physiotherapy is essential for strength and gait correction.

Benefits of Distal Femoral Osteotomy

✅ Preserves the natural knee joint

✅ Reduces pain & improves function

✅ Delays knee replacement for years

✅ Allows return to sports & active lifestyle

✅ Suitable for younger arthritic patients

Possible Risks (Like Any Surgery)

• Infection

• Blood clots

• Plate irritation (may need removal later)

• Under- or over-correction (rare with modern planning)

Your surgeon will discuss these as part of informed decision-making.

Message

"Distal Femoral Osteotomy is a powerful joint-preserving surgery for younger patients with knock-knee arthritis. When chosen correctly, it restores function, activity, and confidence — without jumping to knee replacement."

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About Dr. Kashyap Prabhu Solanki & Dr. Prabhu Solanki

Orthopaedic Surgeon – Andheri, Mumbai

Dr. Kashyap Solanki specializes in hip and knee replacement, robotic-assisted knee surgery, and joint preservation procedures like HTO, arthroscopy, and ligament reconstruction. He is also known for performing complex revision joint replacements and managing challenging upper and lower limb fractures. With a focus on precision and patient-centered care, Dr. Solanki helps restore mobility and improve quality of life through advanced orthopaedic solutions.

With over four decades of distinguished orthopaedic practice, Dr. Prabhu Solanki stands as one of Mumbai’s most experienced and respected orthopaedic surgeons. Having treated more than 40,000 patients and performed over 10,000 surgeries, his clinical outcomes and dedication have earned him widespread recognition — not just in Mumbai, but across India and abroad.

Dr. Solanki’s reputation for precision, ethical care, and long-term results has brought him patients from all over India, as well as international patients seeking high-quality orthopaedic treatment and surgical expertise in Mumbai.

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