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Massive osteochondritis of the lateral femoral condyle associated with discoid meniscus: management with meniscoplasty, rim stabilization and bioabsorbable screw fixation

Camathias, Carloa; Rutz, Ericha; Gaston, Mark S.a,b

Journal of Pediatric Orthopaedics B: September 2012 - Volume 21 - Issue 5 - p 421–424
doi: 10.1097/BPB.0b013e328349ef4f
Knee

Discoid menisci without tears and before surgical intervention may be an aetiological factor in the development of osteochondritis dissecans (OCD). We present the case of a massive OCD lesion in the lateral femoral condyle of a 12-year-old boy who presented with relatively few symptoms despite the size of the lesion. This was treated with meniscoplasty and rim stabilization, which has become established as the gold standard treatment for symptomatic discoid menisci. This was combined with bioabsorbable screw fixation of the OCD lesion, resulting in rapid resolution of symptoms and a return to normal magnetic resonance image appearances after 6 months. It is likely that instability of discoid menisci is a key causal component when present concurrently with OCD lesions. Therefore, stabilization of this is required as well as saucerization of the meniscus. OCD lesions which are of a sufficient size such that if they became unstable or dislocated would result in a significant defect should also be stabilized. We believe that bioabsorbable screw fixation presents a good solution for fixation in these cases and this combination of treatment should result in a satisfactory outcome.

aDepartment of Paediatric Orthopaedics, University Children’s Hospital of Basel (UKBB), Spitalstrasse, Basel, Switzerland

bRoyal Hospital for Sick Children, Edinburgh, UK

Correspondence to Mark S. Gaston, FRCS(Orth) PhD, Royal Hospital for Sick Children of Edinburgh, 9 Sciennes Road, Edinburgh EH9 1LF UK Tel: +44 7811 103381; fax: +44 131 5360852; e-mail: mark.gaston@ed.ac.uk

© 2012 Lippincott Williams & Wilkins, Inc.