Endoscopic resection of symptomatic osteochondroma of the distal femur.

The surgical risk and complication rates for an open excision of a benign osteochondroma have been reported as high as 13%. The advent of minimally invasive techniques allows a surgical resection with a smaller incision and a potential for less postoperative morbidity. We presumed endoscopic resection of symptomatic osteochondroma of the distal femur would decrease postoperative morbidity of open surgery and improve functional outcome. We performed endoscopic resection of a symptomatic osteochondroma in seven patients among 24 who had surgical excision. Preoperative studies include radiographs and computed tomography scans. At a mean followup of 33 months, patients were functionally evaluated according to the Lysholm score and the International Knee Documentation Committee scale. Four exostoses were located at the anterolateral femoral cortex, one at the trochlea, and two at the anteromedial cortex. Histologic diagnosis of an osteochondroma was confirmed in all cases. The average Lysholm score improved 22 points from a mean of 74 preoperatively to 96 postoperatively, and according to the International Knee Documentation Committee scale, all patients showed a normal knee. In 7 of 24 patients with a symptomatic osteochondroma of the distal femur close to the knee, we performed endoscopic resection with low morbidity and prompt functional recovery.