High tibial osteotomy in the treatment of adult osteochondritis dissecans.
This study reports one surgeon's experience using valgus high tibial osteotomy in the treatment of osteochondritis dissecans of the medial femoral condyle in adult patients. Seven knees in six patients with osteochondritis dissecans were reviewed as the basis of the study. Five patients (five knees) were men, and one patient (two knees) was a woman. The average age at surgery was 32 years. Patients reported medial knee pain, recurrent effusions, and disability. An average of three procedures per knee had been performed previously. Four knees had achieved union of the osteochondral fragments but with overlying articular cartilage degeneration observed at arthroscopy. Three knees had failed attempts at fixation with eventual excision of the fragmented osteochondral lesions. None of the knees showed diffuse medial compartment gonarthrosis by radiographic or arthroscopic examinations. Involved knees had relative varus malalignment with an average femoral and tibial angle of 0 degree compared with the uninvolved knees average of 5 degrees valgus. Preoperative technetium scintigraphy showed isolated uptake in the medial femoral condyle of all involved knees. Preoperative Lysholm scores averaged 39 points. Patients were observed for an average of 30 months after surgery. The average Lysholm score at latest followup was 89 points. Femoral and tibial angles averaged 9 degrees valgus. On subjective questioning, all patients reported marked improvement, satisfaction with the surgery, and said they had no need for additional operative intervention.
Slawski
D P
DP
Department of Orthopedic Surgery, USAF Medical Center, Scott Air Force Base, IL, USA.
D000328:Adult; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging; D008297:Male; D010008:Osteochondritis Dissecans / Q000000981:diagnostic imaging / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome