Chondral resurfacing and high tibial osteotomy in the varus knee.
BACKGROUND
Treatment of patients with degenerative knees and varus malalignment presents a difficult clinical problem.


OBJECTIVE
Combining a medial opening wedge high tibial osteotomy with the microfracture chondral resurfacing procedure is a viable treatment option.


METHODS
Retrospective review of prospectively collected data.


METHODS
A group of 38 consecutive patients (mean age, 51.3 years; range, 34 to 72 years; 29 men and 10 women) with varus malalignment and chondral lesions who were treated with chondral resurfacing (an abrasion and microfracture technique) combined with a medial opening wedge high tibial osteotomy. All patients had >5 degrees of varus malalignment. Patients were evaluated preoperatively with the Lysholm and Western Ontario & McMasters Universities Osteoarthritis Index scoring systems and at a minimum of 2 years follow-up.


RESULTS
Thirty-three of 38 patients (87%) were available for 2-year follow-up (average, 45 months; range, 24 to 80 months). Lysholm scores improved from a preoperative score of 43.5 to 78.0 at follow-up; Western Ontario & McMasters Universities Osteoarthritis Index scores improved from 45.8 to 16.2. The average Tegner score was 5.0.


CONCLUSIONS
Combining a medial opening wedge high tibial osteotomy with the microfracture chondral resurfacing procedure in the varus knee is an effective method of decreasing pain and increasing function at a minimum of 2 years follow-up.
Sterett
William I
WI
Steadman-Hawkins Medicine Foundation, Vail, CO 81657, USA.
Steadman
J Richard
JR
D000328:Adult; D000368:Aged; D017760:Bone Malalignment / Q000601:surgery*; D002358:Cartilage, Articular / Q000601:surgery*; D003646:Debridement; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D010146:Pain / Q000209:etiology / Q000601:surgery; D011446:Prospective Studies; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome