Abstract
We present the rationale and technique for treating medial knee osteoarthritis by
dynamically unloading the medial compartment of the knee. Recent advances in kinematic
studies indicate a dynamic linkage between differing degrees of freedom in the knee
joint. Both the adduction moment and the foot progression angle are important determinants
of medial compartment loading. The medially osteoarthritic knee has progressive compromise
of free motion in more than 1 plane. Arthroscopic decompressive medial release unloads
the medial compartment by release of the medial capsule and medial collateral ligament
in the presence of intact cruciate ligaments, which may allow a decreased adduction
moment and decrease of the external rotation restraint in extension found in more
severely osteoarthritic knees. A case series of 38 patients with medial gonarthrosis
was treated by this technique at the Hermanos Ameijeiras Hospital in Havana, Cuba.
All patients had good results without postoperative valgus instability or significant
complications. We feel that this technique warrants further clinical and biomechanical
study for its use in isolation or in combination with high tibial osteotomy or minimally
invasive selective osteotomy for the treatment of medial gonarthrosis of the knee.
A minimally invasive, selective approach to biomechanical factors in osteoarthritis
may be combined with other modulating techniques in efforts to forestall or prevent
the need for total joint replacement.
Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 17, No 5 (May-June),
2001: pp 523–526
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.
