Internal Fixation of Juvenile Osteochondritis Dissecans Lesions of the Knee

@article{Kocher2007InternalFO,
  title={Internal Fixation of Juvenile Osteochondritis Dissecans Lesions of the Knee},
  author={Mininder S Kocher and Joseph J. Czarnecki and Jason S Andersen and Lyle Joseph Micheli},
  journal={The American Journal of Sports Medicine},
  year={2007},
  volume={35},
  pages={712 - 718}
}
Background Operative techniques for the management of juvenile osteochondritis dissecans lesions of the knee include drilling, internal fixation, fragment removal, and chondral resurfacing. Purpose To evaluate the functional and radiographic outcome of internal fixation of juvenile osteochondritis dissecans lesions of the knee. Study Design Case series; Level of evidence, 4. Methods The study design was a retrospective case series. Twenty-six knees in 24 skeletally immature patients underwent… 
Clinical outcome of internal fixation of unstable juvenile osteochondritis dissecans lesions of the knee.
TLDR
The authors recommend bioabsorbable fixation for symptomatic stable lesions and metal compression screws with staged removal for unstable lesions for adolescents who underwent internal fixation for unstable OCD lesions.
Midterm Results of Surgical Treatment for Adult Osteochondritis Dissecans of the Knee
TLDR
Patients with adult osteochondritis dissecans of the knee, treated with surgical cartilage procedures, show durable function and symptomatic improvement at a mean 4.0 years of follow-up.
Surgical management of juvenile osteochondritis dissecans of the knee
TLDR
Surgical treatment of juvenile OCD has significantly improved clinical and radiographic outcomes at short-, mid-, and long-term follow-up, with the exception of poorer results with isolated fragment excision.
Juvenile Osteochondritis Dissecans of the Knee Joint: Midterm Clinical and MRI Outcomes of Arthroscopic Retrograde Drilling and Internal Fixation with Bioabsorbable Pins.
TLDR
Retrograde drilling combined with internal fixation with bioabsorbable pins, of stages II and III OCD lesions of the knee provides good to excellent outcomes to juvenile patients, with a high healing rate.
Autogenous Osteochondral Grafting for Treatment of Knee Osteochondritis Dissecans: A Case Series Study.
TLDR
Surgical treatment of unstable OCD using autogenous osteochondral graft shows successful outcomes in addition to reliable fixation, it can enhance healing and convert an uncontained lesion to contained one appropriate for autogenous bone grafting with healthy cartilage.
Functional and Radiographic Outcomes of Unstable Juvenile Osteochondritis Dissecans of the Knee Treated With Lesion Fixation Using Bioabsorbable Pins
TLDR
The fixation of the unstable juvenile osteochondritis dissecans lesions with bioabsorbable pins demonstrated improved clinical outcomes and radiographic high healing rates at a mean of 3.3 years of follow-up.
Internal Fixation of Unstable Osteochondritis Dissecans: Do Open Growth Plates Improve Healing Rate?
TLDR
Skeletonally immature and mature patients heal at comparable rates after internal fixation of OCD lesions, resulting in functional and subjective improvement.
Operative Results of Osteochondritis Dissecans in the Knee Joints
TLDR
The operative treatments made surgical intervention on the osteochondritis dissecans in the knee joints had good clinical outcome including sports performance.
The Incidence of Surgery in Osteochondritis Dissecans in Children and Adolescents
TLDR
A worse prognosis in the nonoperative treatment of older patients with OCD is confirmed, and the knowledge of likelihood of progression to surgery of OCD by location, sex, and age is useful in counseling patients and in planning treatment.
Juvenile Osteochondritis Dissecans of the Knee
TLDR
Damaged and unsalvageable jOCD lesions or displaced j OCD lesions devoid of subchondral bone are generally treated initially with debridement and abrasion arthroplasty (microfracture).
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TLDR
Given the low morbidity of drilling and the associated improvement in functional and radiographic outcomes, this study advocate arthroscopic transarticular drilling for patients with juvenile osteochondritis dissecans of the medial femoral condyle with an intact articular surface who have had failure of initial nonoperative management.
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TLDR
Arthroscopic compression screw fixation is an effective method of repair for mild to moderately severe cases of osteochondritis dissecans and patients assess their results as excellent or good after 2 years minimum follow-up.
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TLDR
Ten knees in nine patients with large, symptomatic osteochondritis dissecans lesions of the knee were treated by cortical bone peg fixation and MR imaging was a useful tool in evaluating lesion stability, articular cartilage quality, lesion and bone peg incorporation, the menisci, and cruciate ligaments.
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TLDR
Antegrade drilling is an effective method of treatment for osteochondritis dissecans of the knee that occurs in adolescents with open physes but is not as likely to result in a successful outcome in patients with closed physes; consequently, other methods should be considered in skeletally mature patients.
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TLDR
This paper presents a series of 29 patients who were treated surgically for symptomatic osteochondritis dissecans using arthroscopic techniques and indicates a 72% satisfactory result rate when both subjective and objective means of measuring the results are considered.
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TLDR
Arthroscopic Herbert screw fixation is an effective and safe method of repair for osteochondritis dissecans of the knee and the radiographic evidence of healing was correlated with the clinical outcome.
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TLDR
The clinical features in 16 knees included: gradual onset of symptoms, pain with running and jumping, no significant history of injury; inconstant tenderness of the trochlea, and pain with resisted extension at 20 to 45 degrees.
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TLDR
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TLDR
The characteristic feature of osteochondritis dissecans was an expanding concentric lesion at the 'classical' site on the medial femoral condyle which appeared during the second decade of life and progressed to a concave steep-sided defect in the mature skeleton.
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Nineteen patients with 20 osteochondritis dissecans lesions were evaluated between 2 and 20 years after excision of a partially detached (grade III) or loose (grade IV) fragment from the femoral
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