Authors

BÜLENT KILIÇ1, MURAT DEMIROĞLU2, FEYZA ÜNLÜ ÖZKAN3, MEHMET SALIH SÖYLEMEZ4, İSMAIL TÜRKMEN5, YAVUZ SAĞLAM6, KORHAN ÖZKAN7

Departments

1Istanbul Gelişim University, Department of Health Sciences, Orthopaedic Surgeon, Istanbul, Turkey - 2Istanbul Medeniyet University, Goztepe Training and Research Hospital, Department of Orthopaedics and Traumatology, Istanbul, Turkey - 3Fatih Sultan Mehmet Training and Research Hospital, Department of Physical Therapy and Rehabilitation, Istanbul, Turkey - 4Bingöl State Hospital, Department of Orthopaedics and Traumatology, Bingöl, Turkey - 5Beykoz State Hospital, Department of Orthopaedics and Traumatology, Istanbul, Turkey - 6Biruni University, Faculty of Medicine, Department of Orthopaedics and Traumatology, Istanbul, Turkey - 7Istanbul Medeniyet University, Faculty of Medicine, Department of Orthopaedics and Traumatology, Istanbul, Turkey 

Abstract

Osteoarthritis of the knee is leading cause of disability in the elderly, all times. Although there are pharmacological and nonpharmacological treatment methods, these are generally insufficient to alleviate pain and the disability in advanced cases Although total knee arthroplasty improves quality of life and provides a generally high level of patient satisfaction for treatment of advanced gonarthrosis, it is not always without complications. Herein we present a new technique consisting of patellofemoral joint irrigation, simple osteophytectomy if needed, lateral patellar retinaculum release, subchondral drilling of the proximal tibia, percutaneous medial collateral ligament release, intra-articular injection of proximal tibial bone marrow, and the results of this treatment applied under local anesthesia in 20 knees of 13 patients. The mean VAS (Visual Analogue Scale) was 8.20 ± 0.68 prior to treatment and 3.33 ± 0.72 after treatment; the values were 18.67 ± 3.34 and 4.10 ± 3.15 for leg measurements, 7.80 ± 0.77 and 1.07 ± 0.96 for pain, 5.07 ± 2.28 and 1.80 ± 1.42 for walking, and 5.80 ± 0.92 and 1.23 ± 0.92 for daily living activities, respectively. All decreases were statistically significant (p = 0.001 for p < 0.01 in all cases). Biological treatment solutions to gonarthrosis without using foreign materials could decrease the need for prosthetic surgery and its related complications, as well as the need for further attempts at revision. In this study we presented a new biologic treatment for gonarthrosis. 

Keywords

Gonarthrosis, Subchondral drilling, Bone Marrow injection, Osteophytectomy.

DOI:

10.19193/0393-6384_2017_2_050