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This Article Full Text Full Text (PDF) All Versions of this Article: 32/5/1243    most recent 0363546503259301v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (5) Citing Articles via Google Scholar Google Scholar Articles by Sterett, W. I. Articles by Steadman, J. R. Search for Related Content PubMed PubMed Citation Articles by Sterett, W. I. Articles by Steadman, J. R. Related Collections Chondral/cartilage Knee Operative

Chondral Resurfacing and High Tibial Osteotomy in the Varus Knee

From the Steadman Hawkins Sports Medicine Foundation, Vail, Colorado

^* Address correspondence to William I. Sterett, MD, Steadman-Hawkins Clinic, 181 W. Meadow Drive, Suite 400, Vail, CO 81657.

Background: Treatment of patients with degenerative knees and varus malalignment presents a difficult clinical problem.

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

Study Design: 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° 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.

Key Words: high tibial osteotomy • chondral resurfacing • microfracture • degenerative knee • varus malalignment

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