Long-Term Clinical and MRI Results after Refixation of osteochondral Fractures with resorbable Implants. Issue 4 (27th April 2017)

• Record Type: Journal Article
• Authors: Rüther, Hauke; Raschke, David; Frosch, Stefan; Wachowski, Martin; Seif, Ali
• Is Part Of: Orthopaedic journal of sports medicine. Volume 5:Issue 4(2017:Apr.)Supplement 4
• Publication Date: 2017-04-27
• Subjects: Sports medicine -- Periodicals; Orthopedics -- Periodicals; Arthroscopy -- Periodicals; Arthroplasty -- Periodicals; Knee -- Surgery -- Periodicals; 616.7
• DOI: 10.1177/2325967117S00147
• Languages: English
• ISSNs: 2325-9671

Abstract

Aims and Objectives: Refixation with resorbable implants is a common surgical treatment in patients with an osteochondral fracture of the knee or the upper ankle joint. Up to date there are no studies, which outline long-term outcome of this procedure. As a consequence aim of this study was to evaluate the long-term clinical und MRI results. Materials and Methods: In this study 12 patients were examined 13, 9 (#CHR: plusmn# 1, 2) years after refixation of an osteochondral fragment of the knee (10) and the upper ankle joint (2) with a mean size of 3.16 cm 2 (#CHR: plusmn# 2, 27) by resorbable implants (SmartNail, Conmed). We used eight established clinical scores (VASS, Tegner, Lysholm, McDermott, KSS, WOMAC, AOFAS, FADI+Sports). Furthermore we ascertained integration of bone and cartilage morpholgy by MRI (3 Tesla) using proton-weighted- and cartilage-sensitive double-echo-steady-state (DESS) sequences. To identify a possible osteonecrosis we used T1-weighted sequences with a contrast agent (Gadolinum). The morphologic results were objectified with a modified MRI-Score based on Henderson et al. (2003). Results: After 13, 9 (#CHR: plusmn# 1, 2) years the patients with an injury of the knee as well as of the upper ankle joint showed good to excellent results (Knee: VASS: 1, 3 (#CHR: plusmn# 1, 7); Tegener 4, 4 (#CHR: plusmn# 1, 3); Lysholm 85, 7 (#CHR: plusmn# 12, 2); McDermott 90, 7 (#CHR: plusmn# 8, 6); KSS 189 (#CHR: plusmn# 15, 9); WOMAC (6, 16% (#CHR: plusmn# 8, 45)) (Upper Ankle joint: VASS: 2, 5 (#CHR: plusmn# 2, 5); Tegener 5, 5 (#CHR: plusmn# 1, 5); Lysholm 87 (#CHR: plusmn# 13), McDermott 88 (#CHR: plusmn# 12); WOMAC (8, 54% (#CHR: plusmn# 8, 54); AOFAS 75, 5 (#CHR: plusmn# 24, 5); FADI+Sports 118 (#CHR: plusmn# 18)). There was a good integration of the osteochondral fragment in all cases in the MRI. 5 patients showed moderate subchondral cysts. There were changes of the cartilage contour in all patients. The mean Henderson-Score was 14, 4 (#CHR: plusmn# 2, 0) (Best: 8, Worst: 32), which correlates with good results. Conclusion: Because of its good clinical and MRI results the refixation by resorbable implants can be recommended to treat osteochondral flakes.