Percutaneous drilling for the treatment of secondary osteonecrosis of the knee

J Bone Joint Surg Br. 2006 Jun;88(6):740-6. doi: 10.1302/0301-620X.88B6.17459.


Osteonecrosis of the knee comprises two separate disorders, primary spontaneous osteonecrosis which is often a self-limiting condition and secondary osteonecrosis which is associated with risk factors and a poor prognosis. In a series of 61 knees (38 patients) we analysed secondary osteonecrosis of the knee treated by a new technique using multiple small percutaneous 3 mm drillings. Total knee replacement was avoided in 59 knees (97%) at a mean follow-up of 3 years (2 to 4). Of the 61 knees, 56 (92%) had a successful clinical outcome, defined as a Knee Society score greater than 80 points. The procedure was successful in all 24 knees with small lesions compared with 32 of 37 knees (86%) with large lesions. All the procedures were performed as day cases and there were no complications. This technique appears to have a low morbidity, relieves symptoms and delays more invasive surgery.

MeSH terms

  • Adult
  • Female
  • Humans
  • Knee Joint / diagnostic imaging
  • Knee Joint / physiopathology
  • Knee Joint / surgery*
  • Male
  • Middle Aged
  • Orthopedic Procedures / adverse effects
  • Orthopedic Procedures / methods
  • Osteonecrosis / diagnostic imaging
  • Osteonecrosis / physiopathology
  • Osteonecrosis / surgery*
  • Photofluorography / methods
  • Retrospective Studies
  • Treatment Outcome