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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 6, 740-746.
doi: 10.1302/0301-620X.88B6.17459  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Percutaneous drilling for the treatment of secondary osteonecrosis of the knee

G. Marulanda, MD, Clinical Research Fellow1; T. M. Seyler, MD, Clinical Research Fellow1; N. H. Sheikh, Master of Occupational Therapy, Registered and Licensed, Senior Research Programme Manager1; and M. A. Mont, MD, Director1

1 Centre for Joint Preservation and Reconstruction, Rubin Institute for Advanced Orthopaedics, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, Maryland 21215, USA.

Correspondence should be sent to Dr M. A. Mont; e-mail: Mmont{at}lifebridgehealth.org

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.




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M. Takeda, H. Higuchi, M. Kimura, Y. Kobayashi, M. Terauchi, and K. Takagishi
Spontaneous osteonecrosis of the knee: HISTOPATHOLOGICAL DIFFERENCES BETWEEN EARLY AND PROGRESSIVE CASES
J Bone Joint Surg Br, March 1, 2008; 90-B(3): 324 - 329.
[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General