Implant Failure After Biodegradable Screw Fixation in Osteochondritis Dissecans of the Knee in Skeletally Immature Patients

Camathias, Carlo; Gögüs, Ulas; Hirschmann, Michael T.; Rutz, Erich; Brunner, Reinald; Haeni, David; Vavken, Patrick

doi:10.1016/j.arthro.2014.08.032

Cited by 33 publications

(30 citation statements)

References 25 publications

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“…Despite reported failures of OD refixation [ 28 ], this approach showed a better outcome in our case. The Tegner–Lysholm score as well as the MOCART showed a higher value for refixation (Lysholm 95, MOCART 75) in comparison to reconstruction and coverage with collagenous membrane (Lysholm 78, MOCART 65) at 1 year follow-up.…”

Section: Discussionmentioning

confidence: 50%

Direct comparison of different surgical approaches in a woman with bilateral osteochondrosis dissecans of her knees: a case report

2016

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BackgroundOsteochondrosis dissecans is a disorder of the subchondral bone potentially affecting the adjacent articular cartilage. There remains disunity with regard to treatment methods.Case presentationWe present the case of a 21-year-old Swiss woman who presented with clinically symptomatic bilateral osteochondrosis dissecans lesions at both medial femoral condyles. She underwent sequential surgical intervention and was prospectively monitored using clinical scores and magnetic resonance imaging. Her left knee was treated with an open refixation of the osteochondrosis dissecans lesion with two 2.0 mm screws in combination with a cancellous bone graft and subchondral drilling since the cartilage of the osteochondrosis dissecans lesion was intact. On her right knee, she underwent open removal of the defective bone and cartilage, cancellous bone graft with subchondral drilling and coverage with a bilayered collagenous membrane (autologous matrix-induced chondrogenesis technique) since the cartilage of the osteochondrosis dissecans lesion was not intact. At final follow-up 12 months after surgery her Lysholm score had improved from 79 to 95 on her left side and from 74 to 78 on her right. Magnetic resonance imaging displayed good integration of the cancellous bone graft with a slight irregularity at the articular surface on her left side (magnetic resonance observation of cartilage repair tissue (MOCART) 75). The magnetic resonance imaging of her right knee depicted satisfying bony reconstitution with yet more irregularity at the joint surface (magnetic resonance observation of cartilage repair tissue 65) in comparison to her left femoral condyle.ConclusionsIn cases of failed conservative treatment of osteochondrosis dissecans lesions of the knee joint surgery should be taken into consideration. Considering this case, we believe that the focus should be the preservation of the cartilaginous layer whenever possible or at least replacement with high quality replacement tissue, such as autologous chondrocyte implantation.

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Section: Discussionmentioning

confidence: 50%

Direct comparison of different surgical approaches in a woman with bilateral osteochondrosis dissecans of her knees: a case report

2016

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“…Previous studies reported healing rates for skeletally immature patients ranging from 75% to 100% after internal fixation with bioabsorbable and/or metal implants. 2,8,10,16,19,38,40,43 For skeletally mature patients, rates of healing in the literature vary from 67% to 85.7%. 4,23,27,34,41 Several prior investigations combined data of skeletally immature and mature patients because of the smaller sample size, and the reported healing rates (78%-100%) 2,13,21,25,26,30 were closer to those in the skeletally immature studies.…”

Section: Discussionmentioning

confidence: 99%

Internal Fixation of Unstable Osteochondritis Dissecans: Do Open Growth Plates Improve Healing Rate?

Custers

Desai

et al. 2018

Am J Sports Med

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“…However, complications with bioabsorbable implants have been reported, including non-union [35], osteolysis, screw breakage [36], and synovitis [37]. Screw breakage was found in 23 % of bioabsorbable screws used for fixation of OCD lesions in skeletally immature patients.…”

Section: Reparative Transarticular or Retroarticular Drillingmentioning

confidence: 99%

“…Screw breakage was found in 23 % of bioabsorbable screws used for fixation of OCD lesions in skeletally immature patients. The authors noted some of these failures were based on MRI alone and had no clinical symptoms [36].…”

Section: Reparative Transarticular or Retroarticular Drillingmentioning

confidence: 99%

Surgical treatment for osteochondritis dessicans of the knee

Winthrop

Pinkowsky

Hennrikus

2015

Curr Rev Musculoskelet Med

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Osteochondritis dissecans (OCD) of the knee is a disease of the subchondral bone with secondary injury to the overlying articular cartilage. OCD lesions are generally categorized as juvenile-growth plates open-or adult-growth plates closed. This maturity-based classification scheme has a prognostic value in that many juvenile OCD lesions will heal with conservative care while most symptomatic adult OCD lesions need surgical intervention. OCD can result in pain, knee joint effusions, loose body formation, and arthritis. Short-term treatment goals include pain and symptom resolution while the long-term goal is to minimize arthritis. Surgical options include debridement, drilling, microfracture, reduction and fixation, autograft osteochondral transplantation, autologous chondrocyte implantation, and allograft osteochondreal transplantation.

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Implant Failure After Biodegradable Screw Fixation in Osteochondritis Dissecans of the Knee in Skeletally Immature Patients

Cited by 33 publications

References 25 publications

Direct comparison of different surgical approaches in a woman with bilateral osteochondrosis dissecans of her knees: a case report

Direct comparison of different surgical approaches in a woman with bilateral osteochondrosis dissecans of her knees: a case report

Internal Fixation of Unstable Osteochondritis Dissecans: Do Open Growth Plates Improve Healing Rate?

Surgical treatment for osteochondritis dessicans of the knee

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