A hybrid method to Restore a Partially Salvageable Progeny Fragment in Osteochondritis Dissecans of the Knee

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A hybrid method to Restore a Partially Salvageable Progeny Fragment in Osteochondritis Dissecans of the Knee
Key Take-Away: 

The study affirms that the hybrid technique of fixation with osteochondral autograft transfer exhibited positive short-term outcomes and a low complication rate in patients with partially salvageable Osteochondritis Dissecans (OCD) lesions of the knee.

Introduction:

This retrospective case series explains a hybrid fixation method and determined the knee function, clinical outcomes, and activity level of patients when followed for short-term.

 

Method:

All in all, 17 patients (18 knees) with unstable osteochondritis dissecans (OCD) lesions involving the knee were treated with a hybrid fixation method. In this method, the salvageable fragment was treated, and for the unsalvageable fragment, the osteochondral autograft transplantation system (OATS) was used. Thirteen lesions involved the medial femoral condyle, 4 included the lateral femoral condyle, and 1 included the patella. The Mean age of the patient was 17 years (ranging from 12 to 28 years). International Cartilage Repair Society (ICRS) grade III or IV were used for all the lesions. The patients were prospectively followed after the surgery. Outcome measures comprised of the International Knee Documentation Committee (IKDC) score, Tegner activity scale and Knee injury and Osteoarthritis Outcome Score (KOOS).

 

Results:

The mean postoperative KOOS scores, as mean (SD), were: Activities of Daily Living (ADL) 99.5 (1.5), Sport 94.5 (11.2), Pain 97.4 (5.8), Quality of Life (QoL) 91.1 (17.0), and Symptoms 95.9 (6.5). The Mean IKDC score was 96.2 (7.0) at the mean follow-up of 36 months (range 24-67.2 months). No significant difference between mean pre-injury (7.95, SD = 1.1) and mean post-operative (7.45, SD = 1.5) Tegner scores were observed. Mean Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score: 87.5 at 7.8 months (range 3-18 months) after the operation. There were no reported complications.

 

Conclusion:

It was found that the patients with partially salvageable OCD lesions including the knee can have positive short-term outcomes. A low complication rate could be expected when treated with a hybrid method of fixation with osteochondral autograft transfer.

Source

Cartilage

Link:

http://journals.sagepub.com/doi/abs/10.1177/1947603518796132?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed

Original title of article:

Osteochondritis Dissecans of the Knee: Short-Term Outcomes of a Hybrid Technique to Restore a Partially Salvageable Progeny Fragment.

Authors:

Health P Melugin et al.

Exploratory, Osteoarthritis, Osteochondritis Dissecans , Knee, Retrospective case series, Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score, International Knee Documentation Committee (IKDC) score, Knee injury and Osteoarthritis Outcome Score (KOOS), Tegner activity scale
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