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ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2001, Number 4

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Acta Ortop Mex 2001; 15 (4)

Osteonecrosis of the femoral condyle. A report on thirty-two cases

Busto-Villarreal JM, Fernández-Fairén M, Rivas-Jiménez RL, Gutiérrez-Gutiérrez H

Language: Spanish
References: 37
Page: 173-177
PDF size: 46.12 Kb.


ABSTRACT

Objective. To provide surgical treatment for osteonecrosis of the medial femoral condyle. Material and methods. A series of 29 patients (18 women and 11 men) with 32 knees with osteonecrosis of the medial femoral condyle were treated between 1986 and 1992, with an average follow-up of 85 months. Patients were first seen at an average of four months (one to 36) after the onset of symptoms. There were seven cases stage I of Koshino, eight in stage II, 11 in stage III and six in stage IV. Five cases came from stage I to II after three months and in the other two, medial condyle became crushed with medial arthrosis through the following five years. From these five cases and the eight stage II cases, nine became into stage III in one more year with severe medial arthrosis. In stage IV a varus of the knee was evident. Treatment was conservative in seven cases stage I and in four stage II with lesions lesser than 3.5 cm2. When necrotic zone was between 3.5 and 5 cm2, bone drilling by arthroscopy as alone treatment became into failure. Valgus tibial osteotomy was performed in 20 cases stage III. Total knee prosthesis was applied in 16 cases. Results. Best results were obtained when the valgus osteotomy was performed. Results did not improve in six cases in whom osteo-cartilage grafting was applied into the necrotic zone. Conclusion. Whennever varus deformity is present, a tibial valgus osteotomy must be considered, may be as the best treatment advised regardless the stage of osteonecrosis, aiming the unloading of the necrotic condyle and its eventual healing.


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