DEFORMITY CORRECTION
Bowlegs

Bowlegs

Bowlegs

Dong Hoon Lee

Bowlegs
(genu vara)

Bowlegs is a varus deformity marked by (outward) bowing at the knees, which means that the lower leg is angled inward in relation to the thigh's axis, giving the limb an overall appearance of an archer's bow.

Rickets, skeletal dysplasia or other diseases and trauma are possible causes of bowlegs. However, it often occurs without reason (idiopathic). Some degree of bowlegs is normal and does not lead to unhealthy joints. However, even healthy legs might not be cosmetically satisfying to patients.

Each individual has a different degree of deformity, so bowlegs appear differently among individuals. Thus, the surgical approach will vary on a case by case basis according to the cause and form of the deformity. For example, if the doctor tries to correct bowlegs & rotational deformity only with High Tibial Osteotomy, the patient’s knees may stick together, but the operation will lead to another deformity.

Correction of bowlegs is not simply about making the knees stick together; underlying causes must be treated properly in order to form beautiful and healthy legs.

Surgery Case

Angular Deformity Correction

Rotational Deformity Correction

Angular & Rotational Deformity Simultaneous Correction

Surgical Methods

SADO

Simultaneous Angular and Derotational Osteotomy

Features

1Simultaneous correction of angular and rotational deformity with just one surgery (a novel surgical technique developed by Dr. Donghoon Lee)
2Internal fixation only (no external fixator)
3Minimal invasion/cosmetic suture
4No brace or cast after surgery
5Fast recovery (4-6weeks on average)

Patients who visit us with bowlegs often have both angular and rotational deformity. In this case, if the doctor tries to correct the legs only with HTO (High Tibial Osteotomy), the patient’s knees may stick together, but overall leg alignment can seem awkward.

Dr. Donghoon Lee developed an innovative method – Simulataneous Angular and Derotational Osteotomy (SADO) – to correct both, angular and rotational deformity, precisely and simultaneously. With one operation, the most ideal leg alignment can be gained.

The SADO approach not only corrects both deformities at the same time, but also minimizes the possibility of long-term joint problems, such as change in posterior tibia slope or arthritis in the patellofemoral joint.

After surgery, there are no external fixators and the correction of both deformities is complete. Within 2-3 days after the operation, patients can start standing up, and within 4-6 weeks, daily activities can be performed. In 3-4 months, patients can begin to exercise.

Neither a brace nor a cast is needed after surgery.

The scar is sutured very delicately with minimal incision (we are the world’s best).

Angular and Rotational Deformity Correction with SADO

Angular and Rotational Deformity Correction with SADO

MI-OWHTO

Minimally Invasive Open Wedge High Tibial Osteotomy

Features

1This novel surgical method developed by Dr. Donghoon Lee was published in an international academic journal (https://link.springer.com/article/10.1007%2Fs11999-015-4343-5), and introduced as an “Emerging Surgical Technique” by a North-America Limb Lengthening Reconstruction Society.
2Minimal invasion/cosmetic suture
3No brace or cast after surgery
4Fast recovery (4-6weeks)

Of all the different methods used for bowleg correction, High Tibial Osteotomy (HTO) is the most frequently used method to correct simple angular deformity.

The main disadvantage of conventional HTO is that it may accelerate degeneration of the ACL (Anterior Cruciate Ligament) in the long-term, due to increased posterior tibial slope.

The second disadvantage of conventional HTO is that in the long-term, it can have a negative effect on the health of the patellofemoral joint, a very important knee joint.

With a surgical method developed by Dr. Donghoon Lee, Fixator Assisted Distal to Tubercle – High Tibial Osteotomy (FADT-HTO), the tibial slope is preserved. This helps avoid the disadvantages associated with conventional HTO methods.

Bowlegs Correction – Dr. Lee’s HTO

Bowlegs Correction – Dr. Lee’s HTO

CA-EF

Computer Assisted External Fixator System (Ortho-SUV, Hexapod)

Features

1Correction of severe and complicated deformities
2Accurate correction using computer assisted fixator system
3Minimal external pin fixation
4Minimal external fixator attachment in general
5No need for fixation removal surgery, unlike internal fixation

Disadvantages

1External fixator is attached until bone formation (3-5 months)
2Scarring from external fixator pins

With external fixators, we can correct a variety of complex deformities simultaneously.
Although external fixators are not used often for cosmetic deformity correction, this method can still be very useful.

If interested, discuss this option with Donghoon Advanced Limb Lengthening Reconstruction Institute. Dr. Donghoon Lee was the first to introduce Ortho-SUV (computer assisted correctional program using external fixator) in Korea and has the largest volume of Ortho-SUV cases in Korea.