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Functional and Radiographic Outcomes of Unstable Juvenile Osteochondritis Dissecans of the Knee Treated With Lesion Fixation Using Bioabsorbable Pins.
MedLine Citation:
PMID:  24919133     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: The purpose of this study was to evaluate the functional and radiographic outcome of fixation of unstable juvenile osteochondritis dissecans lesions of the knee after a minimum of 2 years of follow-up.
METHODS:: A total of 33 unstable juvenile osteochondritis dissecans lesions in 30 patients underwent fixation using bioabsorbable pins through arthrotomy or under arthroscopy. The patients consisted of 23 males and 7 females, and the average age at the time of operation was 14.4 years (range, 11 to 17 y). The functional outcomes were evaluated using the Lysholm score and Hughston's criteria at a mean follow-up of 3.3 years (range, 2.1 to 6.3 y). Healing of the osteochondritis dissecans lesions were confirmed by plain radiographs and magnetic resonance imaging.
RESULTS:: The Lysholm score improved significantly at 3 months after the surgery, and was maintained until the final follow-up. Radiographically, 32 of 33 lesions healed after fixation of the lesion (healing rate was 97.0%). Healing was achieved at an average of 2.4 months on plain radiographs and 4.2 months on magnetic resonance imaging. According to Hughston's criteria, 25 patients were graded as excellent, 4 as good, and 1 as poor at the final follow-up.
CONCLUSIONS:: 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. We advocate this procedure for patients with unstable juvenile osteochondritis dissecans lesions of sufficient quality to enable fixation which will preserve the normal contour of the distal femur.
LEVEL OF EVIDENCE:: Level IV-retrospective case series.
Authors:
Nobuo Adachi; Masataka Deie; Atsuo Nakamae; Atsushi Okuhara; Goki Kamei; Mitsuo Ochi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-10
Journal Detail:
Title:  Journal of pediatric orthopedics     Volume:  -     ISSN:  1539-2570     ISO Abbreviation:  J Pediatr Orthop     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-6-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8109053     Medline TA:  J Pediatr Orthop     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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