Bilateral Lateral Condyle Lesion with Valgus Deformities of
Bilateral Lateral Condyle Lesion with Valgus Deformities of Lower Extremities Hank Chambers, MD Professor of Clinical Orthopedic Surgery University of California, San Diego
Rady Childrens Hospital, San Diego History 11 y.o. female who presented to clinic with b/l knee pain and difficulty ambulating. 2+
effusion, locking and catching PE: unable to ambulate L side with 15 loss of extension, TTP over b/l LFC Imaging
Imaging Standing EOS Imaging
MRI Right Knee MRI Right Knee
Treatment Bilateral lower extremities: Diagnostic arthroscopy with findings of complete delamination of the cartilage or lateral
compartment almost like a rolled up rug Findings of a cartilage covered ridge in mid portion of the tibial weight bearing surface bilaterally lateral femoral condyle vascular stimulation temporary hemiepiphysiodesis with application of
plates to medial distal femur and proximal tibia 1. Arthroscopy L Knee 1. Arthroscopy R Knee
Study Design: Retrospective study of case series between January 1993 and December 2007 in single ortho dept. Methods: Used b/l full-leg standing radiographs in 93 adolescent and adult patients (103 knees) with OCD of medial
or lateral femoral condyle. Mechanical axis was calculated by the method of Fujisawa et al*: 0% represents knee center 100% represents medial
and lateral border of the joint *Fujisawa Y, Masuhara K, Shiomi S. The effect of high tibial osteotomy on osteoarthritis of the knee: an arthroscopic study of 54 knee joints. Orthop Clin North Am. 1979;10(3):585-608.
Results: Location of OCD and position of mechanical axis in same knee compartment was significantly correlated for both medial (P< 0.001) as well as lateral (P< 0.012) compartment OCD. Significant lateral shift compared to unaffected side. Statistically insignificant medial shift with respect to unaffected side.
Results: No significant difference between adolescents with open growth plates compared with adults with closed growth plates (P > .05).
Conclusion: Association between medial condyle OCD and varus axis and between lateral condyle OCD and valgus axis. Higher loading of the affected than of the unaffected knee compartment. Axial alignment may be a cofactor in OCD of the femoral condyles.
9 b/l cases in medial OCD -- affecting shift calculations? Single institution Relatively small subgroups in sample bias?
The full-leg standing radiographs are not done uniformly at the onset of symptoms many patients were referred later to their institution
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