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Midterm results of surgical treatment for adult osteochondritis dissecans of the knee.
Am J Sports Med 2009; 37 Suppl 1:125S-30SAJ

Abstract

BACKGROUND

Determination of appropriate treatment options for adult osteochondritis dissecans is difficult, as most published papers on surgical osteochondritis dissecans treatment report outcomes in a population consisting of both adult and juvenile patients.

PURPOSE

This study examines the outcomes of surgical procedures in patients with adult osteochondritis dissecans.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

The cohort included 46 adult patients (48 knees) with adult osteochondritis dissecans of the knee who had undergone surgical treatment (debridement, drilling, loose-body removal, arthroscopic reduction and internal fixation, microfracture, osteochondral allograft, or autologous chondrocyte implantation). The average patient age was 34 +/- 9.5 years (range, 20-49) and patients were followed for 4.0 +/- 1.8 years. The mean defect size was 4.5 +/- 2.7 cm(2). Outcomes were assessed via clinical assessment and established outcome scales, including the Lysholm, International Knee Documentation Committee (IKDC), Knee Injury and Osteoarthritis Outcome Score (KOOS), Tegner, Cincinnati, and Short Form-12.

RESULTS

Statistically significant improvement (P < .05) was noted in all outcome scales, including Noyes, Tegner, Lysholm, IKDC, KOOS (subdivided into 5 categories including Pain, Symptoms, Activities of Daily Living, Sport, and Quality of Life), Short Form-12 Physical, and Short Form-12 Mental. Seven knees (14%) had clinical failure of the initial treatment and underwent a revision procedure at a mean follow-up of 14 months. Patients treated with arthroscopic reduction and internal fixation and loose-body removal demonstrated a statistically higher postoperative percentage score increase for the KOOS Sport (P = .008) and KOOS Quality of Life (P = .03) categories than those treated with an osteochondral allograft.

CONCLUSION

Patients with adult osteochondritis dissecans of the knee, treated with surgical cartilage procedures, show durable function and symptomatic improvement at a mean 4.0 years of follow-up. Patients treated with arthroscopic reduction and internal fixation and loose-body removal demonstrated a greater improvement in outcome scores than those treated with osteochondral allograft.

Authors+Show Affiliations

Rush University Medical Center, 1725 West Harrison Street, Chicago, IL 60612, USA. bcole@rushortho.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19861695

Citation

Pascual-Garrido, Cecilia, et al. "Midterm Results of Surgical Treatment for Adult Osteochondritis Dissecans of the Knee." The American Journal of Sports Medicine, vol. 37 Suppl 1, 2009, 125S-30S.
Pascual-Garrido C, Friel NA, Kirk SS, et al. Midterm results of surgical treatment for adult osteochondritis dissecans of the knee. Am J Sports Med. 2009;37 Suppl 1:125S-30S.
Pascual-Garrido, C., Friel, N. A., Kirk, S. S., McNickle, A. G., Bach, B. R., Bush-Joseph, C. A., ... Cole, B. J. (2009). Midterm results of surgical treatment for adult osteochondritis dissecans of the knee. The American Journal of Sports Medicine, 37 Suppl 1, 125S-30S. doi:10.1177/0363546509350833.
Pascual-Garrido C, et al. Midterm Results of Surgical Treatment for Adult Osteochondritis Dissecans of the Knee. Am J Sports Med. 2009;37 Suppl 1:125S-30S. PubMed PMID: 19861695.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Midterm results of surgical treatment for adult osteochondritis dissecans of the knee. AU - Pascual-Garrido,Cecilia, AU - Friel,Nicole A, AU - Kirk,Spencer S, AU - McNickle,Allison G, AU - Bach,Bernard R,Jr AU - Bush-Joseph,Charles A, AU - Verma,Nikhil N, AU - Cole,Brian J, Y1 - 2009/10/27/ PY - 2009/10/29/entrez PY - 2009/10/29/pubmed PY - 2010/3/24/medline SP - 125S EP - 30S JF - The American journal of sports medicine JO - Am J Sports Med VL - 37 Suppl 1 N2 - BACKGROUND: Determination of appropriate treatment options for adult osteochondritis dissecans is difficult, as most published papers on surgical osteochondritis dissecans treatment report outcomes in a population consisting of both adult and juvenile patients. PURPOSE: This study examines the outcomes of surgical procedures in patients with adult osteochondritis dissecans. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: The cohort included 46 adult patients (48 knees) with adult osteochondritis dissecans of the knee who had undergone surgical treatment (debridement, drilling, loose-body removal, arthroscopic reduction and internal fixation, microfracture, osteochondral allograft, or autologous chondrocyte implantation). The average patient age was 34 +/- 9.5 years (range, 20-49) and patients were followed for 4.0 +/- 1.8 years. The mean defect size was 4.5 +/- 2.7 cm(2). Outcomes were assessed via clinical assessment and established outcome scales, including the Lysholm, International Knee Documentation Committee (IKDC), Knee Injury and Osteoarthritis Outcome Score (KOOS), Tegner, Cincinnati, and Short Form-12. RESULTS: Statistically significant improvement (P < .05) was noted in all outcome scales, including Noyes, Tegner, Lysholm, IKDC, KOOS (subdivided into 5 categories including Pain, Symptoms, Activities of Daily Living, Sport, and Quality of Life), Short Form-12 Physical, and Short Form-12 Mental. Seven knees (14%) had clinical failure of the initial treatment and underwent a revision procedure at a mean follow-up of 14 months. Patients treated with arthroscopic reduction and internal fixation and loose-body removal demonstrated a statistically higher postoperative percentage score increase for the KOOS Sport (P = .008) and KOOS Quality of Life (P = .03) categories than those treated with an osteochondral allograft. CONCLUSION: Patients with adult osteochondritis dissecans of the knee, treated with surgical cartilage procedures, show durable function and symptomatic improvement at a mean 4.0 years of follow-up. Patients treated with arthroscopic reduction and internal fixation and loose-body removal demonstrated a greater improvement in outcome scores than those treated with osteochondral allograft. SN - 1552-3365 UR - https://www.unboundmedicine.com/medline/citation/19861695/Midterm_results_of_surgical_treatment_for_adult_osteochondritis_dissecans_of_the_knee_ L2 - http://journals.sagepub.com/doi/full/10.1177/0363546509350833?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -