Midterm Results of Surgical Treatment for Adult Osteochondritis Dissecans of the Knee

Cecilia Pascual-Garrido, Nicole A. Friel, Spencer S. Kirk, Allison G. McNickle, Bernard R. Bach, Charles A. Bush-Joseph, Nikhil N. Verma, Brian J. Cole

Research output: Contribution to journalArticlepeer-review

44 Scopus citations

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, osteo-chondral allograft, or autologous chondrocyte implantation). The average patient age was 34 6 9.5 years (range, 20-49) and patients were followed for 4.0 6 1.8 years. The mean defect size was 4.5 6 2.7 cm2. 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 5.008) and KOOS Quality of Life (P 5.03) 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 osteochon-dral allograft.

Original languageEnglish
Pages (from-to)125S-130S
JournalAmerican Journal of Sports Medicine
Volume37
Issue number1_suppl
DOIs
StatePublished - Nov 1 2009

Keywords

  • adult osteochondritis dissecans (OCD)
  • cartilage
  • knee

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