Long term results of operative treatment of knee osteochondritis dissecans

Fokter, Samo K.; Strahovnik, Andrej; Kos, Darjan; Dovnik, Andraž; Fokter, Nina

doi:10.1007/s00508-012-0230-1

Cited by 2 publications

(1 citation statement)

References 22 publications

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“…More recently, Barret et al [7] analyzed 22 skeletally mature patients treated with metal headless compression‐type screws, documenting radiographic healing in 82% (four patients required re‐operations), with an overall satisfactory activity level and knee function at 8.7 years of follow‐up. Finally, Fokter et al [45] studied retrospectively eight patients at a long follow‐up of mean 14.8 years after treatment with metal compression screws. Since all lesions were healed and stable to arthroscopic probing at 3 months, and the mean IKDC subjective score was 89.9 at final follow‐up, they concluded supporting fragment fixation by compression technique to best preserve the articular surface.…”

Section: Refixation Of the Osteochondral Fragmentmentioning

confidence: 99%

Treatment of unstable knee osteochondritis dissecans in the young adult: results and limitations of surgical strategies—The advantages of allografts to address an osteochondral challenge

Filardo

Andriolo

Soler³

et al. 2018

Knee Surg Sports Traumatol Arthrosc

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Joint surface incongruence resulting from osteochondritis dissecans (OCD) alters the articular physiologic congruence, increasing the contact stress on adjacent joint surfaces and accelerating wear and the cascade of joint degeneration. Accordingly, the restoration of articular surface integrity is of major importance, especially in young adults where, in lesions left untreated or following simple fragment excision, early osteoarthritis can be anticipated. Therefore, the treatment algorithm in unstable knee OCD of the young adult foresees surgical options to restore the articular surface. Several procedures have been proposed, including refixation of the detached fragment bone marrow stimulation, osteochondral autograft implantation, fresh osteochondral allograft transplantation, and cell-based or cell-free regenerative techniques. The aim of this review was to summarize the evidence for these surgical strategies, reporting their results and limitations. The overall evidence documents positive results for each of the assorted surgical procedures applied to treat unstable OCD, thus indicating support for their selected use to treat osteochondral defects paying particular attention to their specific indications for the lesion characteristics. The fixation of a good quality fragment should be pursued as a first option, while unfixable small lesions may benefit from autografts. For large lesions, available cell-based or cell-free osteochondral scaffold are a feasible solution but with limitation in terms of regenerated tissue quality. In this light, fresh allografts may offer articular surface restoration with viable physiologic osteochondral tissue providing a predictably successful outcome, and therefore they may currently represent the most suitable option to treat unstable irreparable OCD lesion in young adults. Level of evidence V.

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Section: Refixation Of the Osteochondral Fragmentmentioning

confidence: 99%