title: Percutaneous drilling for the treatment of secondary osteonecrosis of the knee.
abstract: Osteonecrosis of the knee comprises two separate disorders, primary spontaneous osteonecrosis which is often a self-limiting condition and secondary osteonecrosis which is associated with risk factors and a poor prognosis. In a series of 61 knees (38 patients) we analysed secondary osteonecrosis of the knee treated by a new technique using multiple small percutaneous 3 mm drillings. Total knee replacement was avoided in 59 knees (97%) at a mean follow-up of 3 years (2 to 4). Of the 61 knees, 56 (92%) had a successful clinical outcome, defined as a Knee Society score greater than 80 points. The procedure was successful in all 24 knees with small lesions compared with 32 of 37 knees (86%) with large lesions. All the procedures were performed as day cases and there were no complications. This technique appears to have a low morbidity, relieves symptoms and delays more invasive surgery.
authors.affiliation: Centre for Joint Preservation and Reconstruction, Rubin Institute for Advanced Orthopaedics, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, Maryland 21215, USA.
authors.forename: G
authors.initials: G
authors.lastname: Marulanda
authors.forename: T M
authors.initials: TM
authors.lastname: Seyler
authors.forename: N H
authors.initials: NH
authors.lastname: Sheikh
authors.forename: M A
authors.initials: MA
authors.lastname: Mont
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods; D010020:Osteonecrosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D010779:Photofluorography / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome