Arthroscopic Osteochondral Autograft Transfer for Juvenile Osteochondritis Dissecans of the Humeral Head

Pham, Thuy Trang; Kany, Jean; Lakhal, Walid; Gauzy, Jérôme Sales de; Accadbled, Franck

doi:10.2106/jbjs.cc.17.00003

Cited by 9 publications

(7 citation statements)

References 15 publications

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“…Characteristics of the 14 studies meeting all inclusion criteria can be found in Table 1 . 1-6,17-24 There were 6 retrospective case series, 7 case reports, and 1 prospective case series. This resulted in a total of 100 shoulders in 98 patients.…”

Section: Resultsmentioning

confidence: 99%

“…1 The other 13 studies reported no complications in the perioperative period. 2-6,17-24 The overall rate of failure and/or reoperation ranged from 0% to 35% and 0% to 30%, respectively 6,17,20,23,24 ( Table 3 ). Of note, patients who required reoperation and patients who would choose not to undergo the initial procedure again were considered failures.…”

Section: Resultsmentioning

confidence: 99%

“…1 Patients with glenohumeral cartilage or osteochondral defects may present with a variety of symptoms, including generalized achiness exacerbated with activity, progressive pain to the point of limiting sport activities, constant deep shoulder pain, sharp pain following an acute injury, or progressive crepitation associated with increasing pain. 1-6…”

Section: Introductionmentioning

confidence: 99%

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Articular Cartilage Defects of the Glenohumeral Joint: A Systematic Review of Treatment Options and Outcomes

et al. 2019

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Objective To report radiographic and magnetic resonance imaging findings, patient-reported outcomes, and complications and/or reoperations following nonarthroplasty surgical intervention for focal glenohumeral cartilage defects. Design A literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Patients were included if they possessed a chondral defect of the humeral head, glenoid, or both, which had been treated with a joint preserving nonarthroplasty procedure. Risk of bias assessment was performed using the Methodological Index for Non-Randomized Studies scoring system. Study demographics, surgical technique, imaging findings, patient-reported outcomes, complications, failures, and reoperations were collected. Results Fourteen studies with 98 patients (100 shoulders) met the inclusion criteria. Patient ages ranged from 7 to 74 years. The nonarthroplasty surgical techniques utilized included microfracture (67 shoulders), osteochondral transplantation (28 shoulders), chondrocyte transplantation (4 shoulders), and internal fixation (1 shoulder). The rates of radiographic union and progression of osteoarthritis ranged between 90% to 100% and 57% to 100%, respectively. Visual analog scores ranged from 0 to 1.9 at final follow-up. Mean postoperative ASES (American Shoulder and Elbow Surgeons) shoulder scores ranged from 75.8-100. Mean postoperative CSS (Constant Shoulder Score) scores ranged from 83.3-94. Mean postoperative SSV (Subjective Shoulder Value) ranged from 70% to 99%. Failure and reoperation rates ranged between 0% to 35% and 0% to 30%, respectively, with the most common reoperation being conversion to prosthetic arthroplasty. Conclusions In this systematic review, nonarthroplasty surgical techniques demonstrated acceptable rates of radiographic healing, improved patient reported outcomes, minimal complications, and low rates of failure or reoperation. Joint preserving techniques are likely viable options to prolong function of the native shoulder and provide short- to midterm pain relief in young and highly active patients. Level of Evidence Level IV.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Articular Cartilage Defects of the Glenohumeral Joint: A Systematic Review of Treatment Options and Outcomes

et al. 2019

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“…A recent literature search resulted in 19 case reports describing OCD of the humeral head. For the review of these case reports, we decided to use only the available English reports, which resulted in 13 remaining articles (3)(4)(5)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

Bilateral osteochondritis dissecans of the shoulder

Favier¹,

Janssen²

2022

Acta Orthop Belg

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Osteochondritis dissecans as a pathology is pre-dominantly described in the knee, elbow and ankle. Osteochondritis dissecans of the humeral head is a more uncommon reported injury. We present a case of a bilateral osteochondritis dissecans of the humeral head in a 16-year-old soccer player and an algorithm for treatment of OCD of the humeral head. To our knowledge this has never been described so specifically in literature before.

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“…O joelho é a articulação mais acometida pela osteocondrite dissecante (5) , mas outras articulações podem ser acometidas (5)(6)(7)(8) . A osteocondrite dissecante pode apresentar-se na forma juvenil, quando há presença de fise aberta, ou adulta, quando já existe maturidade esquelética.…”

Section: Discussionunclassified

Fixação com cavilhas ósseas na osteocondrite dissecante do joelho: relato de caso / Bone sticks fixation in osteochondritis dissecans of the knee: case report

Netto

Mestriner

Soares

et al. 2019

Arq Med Hosp Fac Cienc Med Santa Casa São Paulo

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Introdução/Objetivos: A osteocondrite dissecante é uma lesão que acomete o osso subcondral do joelho com efeitos secundários sobre a cartilagem articular. Não há consenso na literatura sobre as melhores opções de tratamento. Reportamos o caso de um paciente submetido a fixação com cavilhas ósseas corticais autólogas, por via aberta. Relato de Caso: Paciente de 16 anos de idade, sexo masculino, com queixa de dor e derrame articular no joelho esquerdo, exacerbados por atividades físicas, havia dez meses, com diagnóstico de osteocondrite dissecante em sua localização mais comum (face lateral do côndilo femoral medial). Paciente foi submetido a tratamento cirúrgico com redução do fragmento e fixação por via aberta, através de cavilhas ósseas corticais retiradas da região anteromedial da tíbia. Resultados: Paciente evoluiu bem, com cicatrização da lesão osteocondral, e boa função no pós-operatório. A fixação com parafusos metálicos permite compressão dos fragmentos, o que favorece a consolidação; entretanto, é necessário a retirada do material após oito semanas. Parafusos biodegradáveis não precisam ser retirados, mas podem evoluir com sinovite asséptica por reação de corpo estranho. A fixação com cavilhas ósseas corticais autólogas, que dispensa a utilização de material de síntese, tem resultados satisfatórios na literatura, e é uma técnica simples, não agressiva, que diminui os custos do procedimento, e que vem sendo menos utilizada nos últimos anos, em detrimento de técnicas mais moderna e mais caras. Conclusão: Este caso enfatiza a eficácia da fixação com cavilhas ósseas no tratamento da osteocondrite dissecante do joelho.Descritores: Joelho, Osteocondrite, Osteocondrite dissecante AbstractIntroduction/Purpose: Osteochondritis dissecans is a lesion that affects the subchondral bone of the knee with secondary effects on joint cartilage. A consensus is yet to be reached on literature about the best treatment option. This case report consists of patient that underwent an open surgery with autologous cortical bone sticks fixation. Case report: 16-year-old patient, male, with pain and joint effusion on the left knee, that gets worse with physical activity, since ten months, with osteochondritis dissecans diagnosis located in the most usual place, in the lateral portion of the medial femoral condyle. Patient went through an open surgery that fixed the fragment with cortical bone sticks withdrawn from anteromedial portion of the tibia. Results: Patient resulted in full recovery, with healing of the osteochondral lesion and good post-operative function. The fixation with metal screws causes compression of the fragments, which is beneficial for the consolidation; however, it is necessary to remove the material after eight weeks. Biodegradable screws don’t need to be removed, but can progress with aseptic synovitis by foreign body reaction. Autologous cortical bone sticks fixation, which does not require the use of synthetic material, has satisfactory results in the literature, and it is a simple, non-aggressive technique that reduces the surgery costs. However, in the recent years, it has been less used in detriment of more modern and expensive techniques. Conclusion: This case report emphasizes the effectiveness of fixation with bone sticks on the treatment of osteochondritis dissecans of the knee.Key words: Knee, Osteochondritis, Osteochondritis dissecans

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Arthroscopic Osteochondral Autograft Transfer for Juvenile Osteochondritis Dissecans of the Humeral Head

Abstract: Arthroscopic osteochondral autograft transfer is an effective option for the treatment of OCD of the humeral head.

Cited by 9 publications

References 15 publications

Articular Cartilage Defects of the Glenohumeral Joint: A Systematic Review of Treatment Options and Outcomes

Articular Cartilage Defects of the Glenohumeral Joint: A Systematic Review of Treatment Options and Outcomes

Bilateral osteochondritis dissecans of the shoulder

Fixação com cavilhas ósseas na osteocondrite dissecante do joelho: relato de caso / Bone sticks fixation in osteochondritis dissecans of the knee: case report

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