ArticleOrthopaedic journal of sports medicine2021
Surgical Fixation of Chondral-Only Fragments of the Knee: A Case Series With a Mean 4-Year Follow-up.
Article in Orthopaedic journal of sports medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Reconstruction of Large Osteochondral Lesions in the Knee: Focus on Fixation Techniques.Life (Basel, Switzerland) · 2021Article
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3 authors.
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Abstract
backgroundChondral-only fragments of the knee have traditionally been treated with excision, with or without cartilage restoration procedures. This is because of the historical assumption that cartilage has limited ability to heal to cancellous or subchondral bone. There is now a growing body of evidence supporting surgical fixation of these fragments. HYPOTHESIS: We hypothesized that surgical fixation of chondral fragments would result in acceptable rates of healing with improvement in clinical outcome scores. STUDY
designCase series; Level of evidence, 4.
methodsData were collected on 15 surgically fixed chondral-only fragments in 14 patients. We retrospectively collected participant demographic information, lesion characteristics, primary mechanism (osteochondritis dissecans vs traumatic shear injury), fixation methods, reoperation information, second-look arthroscopic information, and clinical outcome scores. The mean clinical follow-up was 3.96 years, with a minimum of 1-year follow-up. All patients underwent follow-up magnetic resonance imaging at a mean of 2 years after the index procedure.
resultsThe mean age of our cohort was 17.7 years. We found an 80% survival rate for fixation of the fragments at a mean 4-year follow-up. There were statistically significant improvements in postoperative Knee injury and Osteoarthritis Outcome Score and Tegner scores compared with preoperative scores. Follow-up magnetic resonance imaging scans showed complete healing in 10 knees, partial healing in 2 knees, and loss of fixation in 3 knees. Second-look arthroscopic surgery of 3 knees for reasons other than fragment symptoms showed healing of the fragment, while arthroscopic surgery of 3 symptomatic knees showed loss of fixation.
conclusionSurgical fixation of chondral-only lesions showed an 80% success rate with improvements in the KOOS and Tegner scores.
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