Knee Osteochondritis Dissecans Treated by the AO Hook Fixation System: A Four Year Follow-Up of an Alternative Technique

Abstract

Surgical fixation is recommended for stable osteochondritis dissecans (OCD) lesions that have failed nonoperative management and for all unstable lesions. In this study we set out to describe and evaluate an alternative method of surgical fixation for such lesions. Five knees with unstable OCD lesions in four male adolescent patients with open physes were treated with the AO Hook Fixation System. The outcome was evaluated both clinically and with three separate outcome systems (IKDC 2000, KOOS, Lysholm) at one and a mean four year follow-up. We demonstrated excellent clinical results in all patients. At four years, all scoring systems demonstrated statistically significant improvement when compared to the preoperative status. Our study suggests that the AO Hook Fixation System is an alternative method of surgical intervention with comparable medium term results with other existing modes of fixation and the added biomechanical advantage of the absence of distracting forces during hardware removal.

Knee osteochondritis dissecans-treatment technical aspects

“…Methods for fixating the fragments are as follows: Staples, Plain or threaded Steinman pins 27 , 28 Herbert screws or level countersunk cannulated screws 29 , 30 Absorbable pins 31 , 32 , 33 , 34 Interpositional autogenous osteochondral grafts 35 Fibrin glue + sutures. 36 …”