Abstract
We present a simple surgical technique created by the authors to address degenerative
chondral lesions of the knee and its application in a limited prospective case series.
The technique assumes the concept of beneficial epiphyseal changes caused by disruption
of the subchondral bone in improving symptoms, as with drilling, microfracture, periarticular
osteotomy, and other invasive procedures. Minimally invasive selective osteotomy (MISO)
is an expansion of the arthroscopic treatment of the knee, specifically targeting
symptomatic lesions with minimal additional trauma and cost, while avoiding disruption
of the articular surface of the subchondral bone. The technique involves a mimimal
access approach with selective saw cuts placed with a 1-cm oscillating blade parallel
to the joint surface 1 to 1.5 cm deep to identified lesions. The technique does not
address malalignment but can address lesions not addressed by classic osteotomies
and, as such, may be combined with other corrective alignment procedures as necessary.
We present the results of MISO of the knee in a case series of 62 outpatients carried
out at the Orthopaedic Division of the Clinical and Surgical Hermanos Ameijeiras Hospital
in Havana, Cuba. At 2-year follow-up, there was improvement of symptoms without significant
complications.
Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 17, No 5 (May-June),
2001: pp 510–516
Keywords
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Article info
Footnotes
*Address correspondence and reprint requests to Todd B. Guthrie, M.D., Park Ridge Orthopedics P.A., 27 Doctor’s Dr, Fletcher, NC 28732, U.S.A. E-mail: [email protected]
Identification
Copyright
© 2001 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
