Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Functional and Radiographic Outcomes of Unstable Juvenile Osteochondritis Dissecans of the Knee Treated With Lesion Fixation Using Bioabsorbable Pins

Adachi, Nobuo MD; Deie, Masataka MD; Nakamae, Atsuo MD; Okuhara, Atsushi MD; Kamei, Goki MD; Ochi, Mitsuo MD

Journal of Pediatric Orthopaedics: January 2015 - Volume 35 - Issue 1 - p 82–88
doi: 10.1097/BPO.0000000000000226
Lower Extremity
Buy

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Level of Evidence: Level IV—retrospective case series.

Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan

The authors declare no conflicts of interest.

Reprints: Nobuo Adachi, MD, Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. E-mail: nadachi@hiroshima-u.ac.jp.

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.