Does Internal Fixation for Unstable Osteochondritis Dissecans of the Skeletally Mature Knee Work? A Systematic Review

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
Devin P LelandAaron J Krych

Abstract

To report the rate of radiographic union, patient-reported outcomes, complications, and reoperations after internal fixation of unstable osteochondritis dissecans (OCD) in the skeletally mature knee. A literature search was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Patients were included if they were skeletally mature and underwent internal fixation of an unstable OCD lesion of the knee. Risk of bias assessment was performed using the Methodological Index for Non-randomized Studies scoring system. Surgical technique, rate of union, patient-reported outcomes, complications, and reoperations were collected. Thirteen studies resulted in 148 patients (150 knees) for inclusion. Patient age ranged from 14 to 45 years. Numerous fixation procedures were used, including biodegradable devices (rods, pins, nails, and screws), metal screws, Kirschner wire, and autologous bone sticks. Overall, reported outcome measures were heterogeneous in nature. The rate of radiographic healing ranged from 67% to 100% across 6 studies. Improved subjective results and Hughston criteria on final follow-up ranged from 83% to 100% across 4 studies each. Mean postoperative Lysholm scores ranged from ...Continue Reading

Citations

Mar 10, 2020·Current Reviews in Musculoskeletal Medicine·Crystal A Perkins, S Clifton Willimon
Jan 1, 2021·HSS Journal : the Musculoskeletal Journal of Hospital for Special Surgery·Christopher M BrusalisPeter D Fabricant
Feb 16, 2021·Current Reviews in Musculoskeletal Medicine·Matthew HowellChristopher W Gee
Jun 17, 2021·Revista española de cirugía ortopédica y traumatología·J M BogalloE Guerado

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