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

Abstract

OBJECTIVE:

This retrospective case series describes a hybrid fixation technique and determines the clinical outcomes, knee function, and activity level of patients at short-term follow-up.

DESIGN:

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

RESULTS:

At mean follow-up of 36 months (range 24-67.2 months), the mean postoperative KOOS scores, given as mean (SD), were as follows: Quality of Life (QoL) 91.1 (17.0), Activities of Daily Living (ADL) 99.5 (1.5), Sport 94.5 (11.2), Pain 97.4 (5.8), and Symptoms 95.9 (6.5). Mean IKDC score was 96.2 (7.0). There was no significant difference between mean preinjury (7.95, SD = 1.1) and mean postoperative (7.45, SD = 1.5) Tegner scores (P = 0.363). The mean Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score was 87.5 at a mean 7.8 months (range 3-18 months) postoperation. There were no reported complications.

CONCLUSION:

The results of this case series suggest that patients with partially salvageable OCD lesions involving the knee can have positive short-term outcomes and can expect a low complication rate when treated with a hybrid technique of fixation with osteochondral autograft transfer.

• Authors: Heath P Melugin, Vishal S Desai, Bruce A Levy, Yoshinari Tanaka, Shuji Horibe, Norimasa Nakamura, Aaron J Krych
• Journal: Cartilage (Cartilage) Vol. 11 Issue 3 Pg. 300-308 (07 2020) ISSN: 1947-6043 [Electronic] United States
• PMID: 30141694 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Bone Transplantation (methods)
• Child
• Female
• Femur (transplantation)
• Fracture Fixation (methods)
• Functional Status
• Humans
• Intra-Articular Fractures (etiology, surgery)
• Knee Injuries (etiology, surgery)
• Knee Joint (surgery)
• Male
• Osteochondritis Dissecans (complications, surgery)
• Prospective Studies
• Retrospective Studies
• Severity of Illness Index
• Transplantation, Autologous
• Treatment Outcome
• Young Adult