The purpose of this study was twofold: to evaluate the radiological and clinical results of 33 total knee arthroplasties (TKA) implanted between January 1993 and March 2005, to replace failed medial unicompartmental knee arthroplasty (UKA), and to develop a strategy to deal with bone defects in the tibial plateau. Failure was due to: tibial loosening (15 cases), femoral loosening (five cases), femoral and tibial loosening (two cases), polyethylene wear (five cases), lateral compartment osteoarthritis (two cases), patellofemoral osteoarthritis (two cases), laxity and PE dislocation (one case), and sepsis in one case. In 12 cases the tibial bone defect was filled with a metallic wedge, in seven we used an allograft (femoral head), and in one we used both. We report the results of 27 cases (five patients died and one was lost to follow-up). The mean follow-up was 73±41.7 months (range, 8-153) and the global IKS score was 166.72±21.3 points (range, 128-200). X-rays of the eight allografts showed osteointegration in all cases and no radiolucency was noted.

High tibial osteotomy is commonly used for genu varum deformity in young and active patients. Corrective valgus osteotomy may however lead to an oblique joint line in case of associated femur varum or absence of tibia vara. The correction, needed to obtain long-term good clinical results, may increase the obliquity even more. To avoid this drawback, the authors have performed computer-assisted double osteotomy since 2001. They developed this new technique because combining distal valgus femoral osteotomy and proximal high tibial valgus osteotomy is a demanding technique. The purpose of this article is to present a technical procedure of computer-assisted double level osteotomy and to discuss its rationale and indications.

The incidence of ganglion cysts of the anterior cruciate ligament (ACL) has increased significantly since the advent of MRI, but it remains exceptional in children. We report the case of a 7-year-old boy, with an exceptional imaging exam and histological finding of a ganglion cyst. The lesion was at first an MRI finding with a hypointensity signal on T2-weighted sequences of a normal ACL. An arthroscopy was performed that showed a cyst measuring 40 mm filling the intercondylar notch and involving the roof and the edges of the ACL. A cystography confirmed the position of the cyst, which was removed with specific management of the ACL. Histological examination confirmed the absence of mucoid degeneration, which is always observed in adult lesions. We believe that the ganglion cyst of the ACL in children differs in pathogenesis from common degenerative cyst in adults.

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