Internal Fixation of Osteochondritis Dissecans of the Knee Leads to Good Long-Term Outcomes and High Degree of Healing without Differences between Fixation Devices
Por:
Perelli, S, Romoli, ARM, Costa-Paz, M, Erquicia, JI, Gelber, PE, Monllau, JC
Publicada:
1 nov 2019
Resumen:
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.
Filiaciones:
Perelli, S:
Univ Autonoma Barcelona, Hosp Univ Dexeus, Inst Catala Traumatol & Med Esport ICATME, Barcelona 08028, Spain
Romoli, ARM:
Inst Univ Hosp Italiano Buenos Aires, Res Dept, C1181ach, Buenos Aires, DF, Argentina
Costa-Paz, M:
Hosp Italiano Buenos Aires, Dept Knee Arthroscopy, C1181ach, Buenos Aires, DF, Argentina
Erquicia, JI:
Univ Autonoma Barcelona, Hosp Univ Dexeus, Inst Catala Traumatol & Med Esport ICATME, Barcelona 08028, Spain
Gelber, PE:
Univ Autonoma Barcelona, Hosp Univ Dexeus, Inst Catala Traumatol & Med Esport ICATME, Barcelona 08028, Spain
Univ Autonoma Barcelona, Hosp Sta Creu & St Pau, Dept Orthopaed Surg, Barcelona 08028, Spain
Monllau, JC:
Univ Autonoma Barcelona, Hosp Univ Dexeus, Inst Catala Traumatol & Med Esport ICATME, Barcelona 08028, Spain
Univ Autonoma Barcelona, Hosp del Mar, Dept Orthopaed Surg, Barcelona 08028, Spain
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