Successful treatment of pediatric osteochondritis dissecans of the knee using a wrist arthroscope: A case report with long term follow-up.

introduction and importanceOsteochondritis dissecans (OCD) is a rare joint disorder that affects the subchondral bone and surrounding articular cartilage, resulting in localized necrosis and possible detachment of both bone and cartilage pieces. It primarily manifests in the knee joints of juvenile and teenage patients, and is frequently associated with recurring joint stress. CASE PRESENTATION: An 8-year-old child presented with a three-month history of left knee pain, exacerbated by movement, which resulted in a limp. Clinical examination revealed knee edema, limited range of motion, and 30-degree extension limitation. Imaging revealed a chondral defect in the medial condyle accompanied by a detached cartilage flap. Arthroscopic surgery was performed using a wrist arthroscope for debridement and microfractures, followed by fibrin glue application. Postoperatively, the patient showed considerable improvement, achieving complete restoration of knee mobility, and a Lysholm knee score of 93. CLINICAL DISCUSSION: Addressing OCD in pediatric patients presents distinct problems owing to their reduced joint size and open growth plates. Wrist arthroscopes enhance precision in pediatric patients and reduce harm to adjacent cartilage and soft tissues. Conservative therapy may be sufficient for stable lesions; however, surgical intervention is required in unstable cases.

conclusionThis case illustrates the effective use of wrist arthroscope for the management of pediatric knee diseases. The small equipment facilitated accurate and efficient intervention, improved outcomes, and emphasized the importance of properly sized tools in pediatric orthopedic treatments.