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  • Title: Chondral resurfacing and high tibial osteotomy in the varus knee.
    Author: Sterett WI, Steadman JR.
    Journal: Am J Sports Med; 2004; 32(5):1243-9. PubMed ID: 15262649.
    Abstract:
    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 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.
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