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Long term results of operative treatment of knee osteochondritis dissecans

Langzeitergebnisse der operativen Behandlung der Osteochondritis dissecans am Kniegelenk

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Summary

Purpose

This retrospective study was designed to evaluate the hypothesis that open reduction internal fixation (ORIF) of an unstable osteochondritis dissecans (OCD) lesion results in a high percentage of acceptable outcomes at long-term follow-up.

Methods

Eight patients who had been treated with ORIF for unstable knee OCD lesions were identified. Long-term outcomes were assessed with a Subjective Knee Evaluation Form and Knee Examination Form of the International Knee Documentation Committee (IKDC 2000) and an OCD specific Hughston rating scale.

Results

All lesions were healed and stable to arthroscopic probing at 3 months. At the average follow-up of 14.8 years (range 12–21 years), the mean IKDC subjective score was 80.9. In IKDC examination form, six patients reached group A (normal) and two patients reached groups B (near normal) and C (abnormal), respectively. According to Hughston criteria, three patients were rated excellent, three good, one fair, and one poor.

Conclusions

We recommend aggressive attempts to preserve articular cartilage in OCD.

Zusammenfassung

Ziel der Studie

Diese retrospektive Studie soll die Hypothese prüfen, ob die open reduction internal fixation (ORIF) einer instabilen Osteochondritis dissecans (OCD) Läsion akzeptable Langzeitergebnisse liefert.

Methodik

Es wurden acht Patienten, bei denen eine ORIF wegen einer instabilen Knie-OCD-Läsion durchgeführt worden war, in die Studie aufgenommen. Die Langzeitergebnisse wurden mittels eines subjektiven Fragebogens sowie mittels eines Knie-Untersuchungsformblatts des internationalen Komitees zur Knie-Dokumentation (IKDC 2000) und mittels einer OCD spezifischen Hughston Bewertungsskala erhoben.

Ergebnisse

Nach 3 Monaten waren alle Läsionen verheilt und arthroskopisch stabil. Bei einer im Durchschnitt 14,8 Jahre (12–21 Jahre) nach der Operation durchgeführten Kontrolle lagen die mittleren IKDC Scores bei 80,9. Bei der IKDC Untersuchung erreichten sechs Patienten die Gruppe A (= normal), zwei Patienten die Gruppe B (fast normal) beziehungsweise die Gruppe C (abnormal). Nach den Hughston Kriterien waren drei Patienten ausgezeichnet, drei gut, eins mittel und eins schlecht.

Schlussfolgerungen

Wir empfehlen aggressive Versuche, den Gelenksknorpel bei OCD zu erhalten.

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Conflict of interest

The authors declare that there is no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery and Sports Trauma, Celje General Hospital, Oblakova 5, 3000, Celje, Slovenia

    Samo K. Fokter MD, PhD & Andrej Strahovnik MD, MSc

  2. Maribor University Clinical Centre, Ljubljanska 5, 2000, Maribor, Slovenia

    Darjan Kos MD, Andraž Dovnik MD & Nina Fokter MD

Authors
  1. Samo K. Fokter MD, PhD
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  2. Andrej Strahovnik MD, MSc
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  3. Darjan Kos MD
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  4. Andraž Dovnik MD
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  5. Nina Fokter MD
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Corresponding author

Correspondence to Andrej Strahovnik MD, MSc.

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Level of evidence Therapeutic Study Level IV (Case series)

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Fokter, S., Strahovnik, A., Kos, D. et al. Long term results of operative treatment of knee osteochondritis dissecans. Wien Klin Wochenschr 124, 699–703 (2012). https://doi.org/10.1007/s00508-012-0230-1

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  • DOI: https://doi.org/10.1007/s00508-012-0230-1

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