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Open AccessArticle

Internal Fixation of Osteochondritis Dissecans of the Knee Leads to Good Long-Term Outcomes and High Degree of Healing without Differences between Fixation Devices

1
Institut Català de Traumatologia i Medicina de l’Esport (ICATME)—Hospital Universitari Dexeus, Universitat Autònoma de Barcelona, 08028 Barcelona, Spain
2
Research Department, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires c1181ach, Argentina
3
Department of Knee Arthroscopy, Hospital Italiano de Buenos Aires, Buenos Aires c1181ach, Argentina
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Department of Orthopaedic Surgery, Hospital de la Sta Creu i Sant Pau, Universitat Autònoma de Barcelona, 08028 Barcelona, Spain
5
Department of Orthopaedic Surgery, Hospital del Mar, Universitat Autònoma de Barcelona, 08028 Barcelona, Spain
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(11), 1934; https://doi.org/10.3390/jcm8111934
Received: 19 September 2019 / Revised: 31 October 2019 / Accepted: 7 November 2019 / Published: 10 November 2019
(This article belongs to the Section Orthopedics)
The aim of the present study is to describe results at long-term follow-up of internal fixation of unstable Osteochondritis Dissecans (OCD) achieved with three different fixation devices in skeletally mature knees. A retrospective cohort study was performed at 5 to 19 years follow-up. Patient-reported questionnaires were collected at the final follow-up. Postoperative X-rays and MRIs were evaluated for healing of the lesion and articular degeneration. An arthroscopic second look was performed in 74.3% of the cases. Failures were reported as reintervention to address the osteochondral lesion or poor functional outcomes at the last follow-up. A total of 39 subjects with a median follow-up of 10.7 years were included. Herbert screws were used in 51.2% of the cases, bioabsorbable nails in 25.7% of the cases and cannulated screws in 23.1% of the cases. No differences were observed in terms of the clinical score (International Knee Documentation Committee (IKDC) p = 0.211; Lysholm p = 0.197), radiographic union (p = 0.102) or radiographic degeneration (p = 0.238) between the three different fixation devices. Arthroscopic second look found complete stability of the lesions in all 29 cases evaluated. The mean postoperative Lysholm score was 83 (range = 33–100) and IKDC score was 79 (range = 39–100). Radiographic union was seen in 74% of the cases. Lack of radiographic union was correlated with worst functional scores. A failure rate of 20.5% was found: four reinterventions were performed, and four patients had poor scores at last follow up. This study shows that internal fixation of condylar OCD in skeletally mature patients provides good long-term clinical results and a high degree of healing regardless of the dimensions of the lesion and type of fixation. View Full-Text
Keywords: osteochondritis dissecans; OCD; internal fixation; skeletally mature knee osteochondritis dissecans; OCD; internal fixation; skeletally mature knee
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MDPI and ACS Style

Perelli, S.; Molina Romoli, A.R.; Costa-Paz, M.; Erquicia, J.I.; Gelber, P.E.; Monllau, J.C. Internal Fixation of Osteochondritis Dissecans of the Knee Leads to Good Long-Term Outcomes and High Degree of Healing without Differences between Fixation Devices. J. Clin. Med. 2019, 8, 1934.

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