Osteochondritis dissecans: A historical review and its treatment with cannulated screws

Comparison of the stability of various internal fixators used in the treatment of osteochondritis dissecans—a mechanical model

“…It is unlikely that a single implant is ideal in all circumstances. Based on our observations and outcomes reported from clinical studies, 3,[8][9][10]12 an osteochondral fragment seated within its bed might require the least stiff fixation device. However, in the context of a mismatch between the defect site and its corresponding fragment, OCD might be more amenable to rigid fixation with a compression screw system.…”

“…3,[8][9][10][11] While no defined mechanism of failure following fixation has been identified, we suspect that subjecting the repair site to loads in shear is a contributing factor. Our results revealed all methods of internal fixation performed significantly better than the control, with the construct using the longest AO screw and threaded washer providing the greatest stability.…”

“…3,[8][9][10][11][12] Surgical treatment is reserved for the patient with JOCD that has failed conservative measures and for those who are skeletally mature at the time of presentation. A variety of fixation methods have been used successfully in achieving fracture healing, including Kirschner wire (K-wire) fixation, 3,9 cannulated screws, 10 Herbert screws, 13 compression screws, 14 biodegradable rods, 15 biologic fixation with autogenous osteochondral plugs, 16 and nonabsorbable sutures. 17 No biomechanical or clinical studies exist to assist the surgeon with the selection of a particular fixation device or technique.…”

Osteochondritis Dissecans of the Knee

“…The majority of patients undergoing this technique report good to excellent results without major complications [60][61][62]. The use of cannulated screws has also been described with successful results; however, the major drawback is the concern for increased articular cartilage morbidity due to screw prominence on the articular surface [63,64]. Cannulated headless compression screws have now been developed as an alternative, which theoretically combines the advantages of both techniques [65].…”

Möglichkeiten minimal-chirurgischer Maßnahmen am Kniegelenk

“…Ist das Dissekat bereits erheblich gelockert, jedoch noch vital und unfragmentiert, kann eine Verschraubung unter arthroskopischer Kontrolle erwogen werden. Kanu È lierte Schrauben sind zu bevorzugen, die Schraubenko È pfe mu È ssen versenkt werden und die Implantate sollten baldmo È glichst wieder entfernt werden [17]. Die Verwendung von Doppelgewindeschrauben ist fu È r diese Indikation ebenfalls beschrieben worden [46,54].…”