The arthroscopic treatment of osteochondritis dissecans of the knee with autologous bone sticks

Navarro, Ricardo Dizioli; Cohen, Moisés; Filho, Mário Carneiro; Silva, Rogério Teixeira da

doi:10.1053/jars.2002.36141

Cited by 50 publications

(25 citation statements)

References 8 publications

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“…12, 20, 29, 60 Reported healing rates by radiograph have been between 80 and 100% with good to excellent clinical outcomes in the majority of patients. 1, 13, 16, 21, 28, 30, 34, 40, 43, 44, 48, 54 …”

Section: Introductionmentioning

confidence: 99%

Does Operative Fixation of an Osteochondritis Dissecans Loose Body Result in Healing and Long-Term Maintenance of Knee Function?

2009

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Background Osteochondritis dissecans (OCD) can progress to loose body formation resulting in a Grade IV defect. The decision to fix versus excise the loose body is controversial. Published operative fixation outcomes are small case series with short follow-up. Hypothesis Operative fixation (ORIF) of the loose body into the grade IV defect will heal and approximate “normal” knee function at long-term follow-up. Study Design Case series Methods Twelve patients were identified who underwent ORIF of a knee OCD loose body into the Grade IV osteochondral defects ranging in size from 2.0 to 8.0 cm2 (mean 3.5 cm2). After 12 weeks, hardware was removed and healing was assessed. Long-term outcomes were assessed with a Knee injury and Osteoarthritis Outcome Score (KOOS) and a Marx activity score. Results Arthroscopy for screw removal revealed stable healing in 92% (11/12) of patients. No patients required subsequent surgery for a loose body. At an average of 9.2 years follow-up (range 3.8-15.8 years) 83 % (10/12) of patients completed the KOOS. KOOS subscale scores for pain (mean 87.8, range 67-100), other symptoms (mean 81.8, range 61-96), function in activities of daily living (mean 93.1, range 72-100), and sports and recreation function (mean 74.0, range 40-100) were not significantly lower than published age matched controls. However the KOOS subscale for knee related quality of life (mean 61.9, range 31-88) was significantly lower (p = 0.003). Conclusions Operative fixation of Grade IV OCD loose bodies results in stable fixation. At an average 9 years after surgery, patients did not have symptoms of osteoarthritis pain and had normal function in activities of daily life. However, patients reported significantly lower knee related quality of life. Operative fixation of OCD loose bodies is a better alternative to lesion excision.

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Section: Introductionmentioning

confidence: 99%

Does Operative Fixation of an Osteochondritis Dissecans Loose Body Result in Healing and Long-Term Maintenance of Knee Function?

2009

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“…In the literature it is proposed the use of metallic threads or synthetic's 4,5 , metallic pins or of material degradável 4 , biological adhesives or synthetic's 4,7 , among others. In the most extensive lesions they exist proposed of using cartilage solemnity-graft or homoenxerto 4,12 .…”

Section: Discussionmentioning

confidence: 99%

“…The fixation in mosaic 13 or of larger fragments he/she has their results harnessed to the use of the applied technique. The fixation way of the fragments to the receiving bed is important factor in the evolution of the doença 12,13 . Like this, it has been seeking alternatives in the genetic engineering, transplant's 14 or biomaterials.…”

Section: Discussionmentioning

confidence: 99%

The use of resorcine adhesive in repairing osteochondral's defect in knees of rabbits

Sakihama¹,

Fagundes

Inouye

et al. 2006

Acta Cir. Bras.

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“…Despite extensive research on how to fix large osteochondral fragments [10][11][12][13][14][15], very few studies (focusing on osteochondritis dissecans) have examined the histological appearance of osteochondral detachment [16][17][18]. A study analyzed the histological appearance of healed OCFs in humans [3], but no study has analyzed the histological appearance of late-diagnosed OCFs.…”

Section: Introductionmentioning

confidence: 99%

Late-diagnosed large osteochondral fracture of the lateral femoral condyle in an adolescent

Enea

Busilacchi

Cecconi

et al. 2013

Journal of Pediatric Orthopaedics B

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In this case report, we describe a large osteochondral fracture of the anterolateral femoral condyle in an adolescent athlete while dancing. At 3 months after the misdiagnosed injury, the condylar defect was covered by a layer of disorganized fibrous tissue rich in blood vessels. To achieve good repair, an accurate curettage of the fractured surfaces, a precise reduction, and a stable internal fixation of the fragments were performed. Two poly-L-lactic acid bioabsorbable screws were used to obtain appropriate compression. At the 2-year follow-up, the patient was asymptomatic and had resumed her previous dancing activity. An MRI scan showed no interruptions of the cartilage layer at the boundary with the healthy tissue, but cartilage thinning and extensive subchondral remodeling were detected.

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The arthroscopic treatment of osteochondritis dissecans of the knee with autologous bone sticks

Cited by 50 publications

References 8 publications

Does Operative Fixation of an Osteochondritis Dissecans Loose Body Result in Healing and Long-Term Maintenance of Knee Function?

Does Operative Fixation of an Osteochondritis Dissecans Loose Body Result in Healing and Long-Term Maintenance of Knee Function?

The use of resorcine adhesive in repairing osteochondral's defect in knees of rabbits

Late-diagnosed large osteochondral fracture of the lateral femoral condyle in an adolescent

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