Fixation of Unstable Osteochondritis Dissecans Lesions and Displaced Osteochondral Fragments Using New Biodegradable Magnesium Pins in Adolescents

Abstract

Objective Fixation of unstable osteochondritis dissecans (OCD) lesions and displaced osteochondral fragments are frequently performed procedures in pediatric orthopedic surgery. Since 2018, CE-certified MAGNEZIX pins are used in our institution in these cases. The aim of this study was (1) to analyze safety, efficiency, and limitations of magnesium-pin-based fixation of unstable OCD lesions and displaced osteochondral fragments and (2) to report clinical and radiological outcomes at short-term follow-up (FU). Design In this prospective cohort study, 19 patients (10 girls and 9 boys) were included. Inclusion criteria were (1) magnetic resonance imaging–confirmed unstable OCD lesion or displaced osteochondral fragment, (2) fixation with magnesium-based pins, and (3) minimum FU of 6 months. X-rays were taken 6 weeks and 6 months after operation and magnetic resonance imaging scans every 4 to 6 months to assess the healing progress. Results In total 67 pins were used, with a mean of 3.6 ± 1.4 per patient. Average age at surgery was 13.7 years (11-17 years). Mean time of operation was 56 ± 31 minutes, including arthroscopy, fixation, and patellar realignment ( n = 6). No intraoperative complications occurred. Average FU was 11.3 ± 4.2 months (6-20 months). No redislocation or new dislocation occurred. Until now a complete radiographic healing occurred in 12 cases. Due to an implant failure in one case 11 weeks after the index surgery a revision became necessary. Conclusions In short-term FU of 11 ± 4 months MAGNEZIX pins provide high stability after fixation of unstable OCDs and displaced osteochondral fragments leading to uncomplicated and timely healing.

Bioresorbable Magnesium-Based Alloys as Novel Biomaterials in Oral Bone Regeneration: General Review and Clinical Perspectives

“…MgYREZr screws were initially investigated for hallux valgus and medial malleolar fracture [ 85 , 88 ]. MgYREZr pins were evaluated for osteochondritis dissecans lesions and displaced osteochondral fragments [ 102 , 110 ].…”

Use of resorbable magnesium screws in children: Systematic review of the literature and short-term follow-up from our series

“…Implant corrosion was evident after two months, with minimum radiolucent space around the screws, as previously reported. 21 , 30 None of the patients developed local pain, swelling or other clinical signs of discomfort or intolerance to the implant, thus there was no need for second surgery in any of the patients. It is worth underlining that implant removal represents nearly 35% of the annual surgical burden of our centre.…”

“…Only one case report revealed implant failure after Scapho-Trapezo-Trapezoideal arthrodesis, leading to revision surgery 22 ( Table 2 ). 13 , 14 , 16 , 17 21 - 34 …”

“…Jungesblut et al, 21 prospectively analyzed a cohort of 19 patients (mean age 13.7 years (sd 1.9; 11 to 17); ten female, nine male) after open or arthroscopic fixation of unstable OCD lesions or displaced osteochondral fragments with resorbable Mg pins. The aim of that study was to analyze the safety, efficacy and limitations of Mg pin-based fixation of unstable OCD lesions and displaced osteochondral fragments, analyzing clinical and radiological outcomes at a minimum of six months FU.…”

“…The MgYREZr screw demonstrated similar efficacy in functional and radiological outcomes in modified Chevron osteotomy in hallux valgus, 23 medial malleolar fracture 44 and good clinical outcome in other isolated reports. 29 , 33 All these studies, indeed, are conducted in adult populations, with the only exception being Jungesblut et al 21 , reporting on an average age of 13.7 years. Nonetheless, according to inclusion criteria we cannot tell if some of the patients had already reached skeletal maturity.…”