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Keywords = osteochondral refixation

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12 pages, 3068 KiB  
Article
Long-Term Outcome and Athletic Level following Operative Treatment for Osteochondritis Dissecans of the Knee in Pediatric and Adolescent Patients
by Yannic Bangert, Patrick Zarembowicz, Karoly Engelleiter, Evangelos Gkarilas, Holger Schmitt, Tobias Renkawitz and Ayham Jaber
J. Clin. Med. 2023, 12(12), 4140; https://doi.org/10.3390/jcm12124140 - 20 Jun 2023
Cited by 4 | Viewed by 2399
Abstract
Research on the long-term outcomes following surgical therapy for osteochondritis dissecans (OCD) of the knee is scarce. A single-center retrospective cohort study was conducted to investigate surgically treated patients for knee OCD between 1993 and 2007. A total of 37 patients with an [...] Read more.
Research on the long-term outcomes following surgical therapy for osteochondritis dissecans (OCD) of the knee is scarce. A single-center retrospective cohort study was conducted to investigate surgically treated patients for knee OCD between 1993 and 2007. A total of 37 patients with an average follow-up duration of 14 years (range 8–18) were in the final cohort. IKDC and Lysholm scores were assessed. The duration and types of sport activity were reported. Long-term results were compared with existing midterm data. Knee scores showed a very good outcome with a mean of 91.3 in the IKDC score and 91.7 in the Lysholm score. Compared to midterm outcomes, both IKDC (p = 0.028) and Lysholm scores (p = 0.01) improved on final follow-up. Patients with open physes showed a significantly better Lysholm score compared to patients with closed physes (p = 0.034). Defect localization and size did not influence the outcome, but a defect depth of <0.8 cm2 achieved significantly better scores than ≥0.8 cm2. Of all surgical interventions, refixation achieved the best outcome. Long-term results significantly improved compared to midterm results with a follow-up of 40 months (p = 0.01). Thirty-six out of 37 patients were physically active, with 56% of sports being knee-straining activities. Long-term results following surgically treated OCD fragments show excellent function and a good athletic level. Patients with open physes potentially have better knee outcomes. Midterm results are sustainable and could improve further in the long term. Full article
(This article belongs to the Section Orthopedics)
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10 pages, 3053 KiB  
Case Report
Refixation of a Large Osteochondral Fragment with Magnesium Compression Screws—A Case Report
by Adrian Deichsel, Lucas Klaus Palma Kries, Michael J. Raschke, Christian Peez, Thorben Briese, Johannes Glasbrenner, Elmar Herbst and Christoph Kittl
Life 2023, 13(5), 1179; https://doi.org/10.3390/life13051179 - 12 May 2023
Cited by 3 | Viewed by 2133
Abstract
Introduction: Osteochondrosis dissecans (OCD) is a disease affecting the subchondral bone and the overlying articular cartilage. The etiology is most likely a combination of biological and mechanical factors. The incidence is highest in children >12 years old and it predominantly affects the knee. [...] Read more.
Introduction: Osteochondrosis dissecans (OCD) is a disease affecting the subchondral bone and the overlying articular cartilage. The etiology is most likely a combination of biological and mechanical factors. The incidence is highest in children >12 years old and it predominantly affects the knee. In high-grade OCD lesions, free osteochondral fragments usually are refixed via titanium screws or biodegradable screws or pins. In this case, headless compression screws made from magnesium were used for refixation. Case report: A thirteen-year-old female patient with a two-year history of knee pain was diagnosed with an OCD lesion of the medial femoral condyle. After initial conservative treatment, displacement of the osteochondral fragment occurred. Refixation was performed using two headless magnesium compression screws. At the 6 months follow up, the patient was pain free, and the fragment showed progressive healing while the implants were biodegrading. Discussion: Existing implants for refixation of OCD lesions either require subsequent removal or show less stability and possible inflammatory reactions. The new generation of magnesium screws used in this case did not lead to a gas release, as described for previous magnesium implants, while maintaining stability during continuous biodegradation. Conclusions: The data available to date on magnesium implants for the treatment of OCD are promising. However, the evidence on the magnesium implants in refixation surgery of OCD lesions is still limited. Further research needs to be conducted to provide data on outcomes and possible complications. Full article
(This article belongs to the Special Issue Osteochondral Lesions: Current Knowledge and Future Perspectives)
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