Functional and Radiographic Outcomes of Unstable Juvenile Osteochondritis Dissecans of the Knee Treated With Lesion Fixation Using Bioabsorbable Pins. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Adachi, Nobuo; Deie, Masataka; Nakamae, Atsuo; Okuhara, Atsushi; Kamei, Goki; Ochi, Mitsuo
• Is Part Of: Journal of pediatric orthopaedics. Volume 35:Issue 1(2015)
• Publication Date: 2015-01
• Subjects: Pediatric orthopedics -- Periodicals; 618.927
• DOI: 10.1097/BPO.0000000000000226
• Languages: English
• ISSNs: 0271-6798

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Background:</title> <p>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.</p> </sec> <sec> <title>Methods:</title> <p>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.</p> </sec> <sec> <title>Results:</title> <p>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.</p> </sec> <sec> <title>Conclusions:</title> <p>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.</p> </sec> <sec> <title>Level of Evidence:</title> <p>Level IV—retrospective case series.</p> </sec> </abstract>