PURPOSE: We sought to evaluate the functional and radiographic outcome of osteochondral lesions involving the femoral condyle that were arthroscopically repaired via a bioabsorbable fixation device made of self-reinforced poly-L-lactic acid. METHODS: A retrospective clinical and radiographic evaluation of 9 patients (8 male and 1 female) with a mean age of 18 years at the time of surgery was carried out. Of these patients, 8 were diagnosed with osteochondritis dissecans and 1 had a traumatic chondral fracture. All patients underwent arthroscopic repair of a discrete osteochondral lesion involving the femoral condyle with a bioabsorbable fixation implant. All patients were evaluated at a mean of 33 months postoperatively. All patients had preoperative magnetic resonance imaging (MRI) documenting the integrity and location of the fragment. Patients were evaluated at follow-up with a physical examination, Lysholm questionnaire, and repeated MRI with specific cartilage pulse sequencing. RESULTS: At surgery, the mean size of the fragment was 2 x 2 cm. A mean of 4 nails was used in each case (range, 2 to 10). All patients were treated with a postoperative rehabilitation protocol of non-weight-bearing for a minimum of 6 weeks. The mean postoperative Lysholm score was 94 (range, 78 to 100). The outcomes were excellent in 7 patients, good in 1, and fair in 1. After surgery, MRI evaluation of the osteochondral lesion and overlying cartilage was graded as healed in 7 patients and of questionable integrity in 2. CONCLUSIONS: This report documents the efficacy of a bioabsorbable nail to internally fix osteochondral lesions. It supports the use of MRI for both preoperative planning and postoperative assessment of fragment healing. LEVEL OF EVIDENCE: Level IV, therapeutic case series.
PURPOSE: We sought to evaluate the functional and radiographic outcome of osteochondral lesions involving the femoral condyle that were arthroscopically repaired via a bioabsorbable fixation device made of self-reinforced poly-L-lactic acid. METHODS: A retrospective clinical and radiographic evaluation of 9 patients (8 male and 1 female) with a mean age of 18 years at the time of surgery was carried out. Of these patients, 8 were diagnosed with osteochondritis dissecans and 1 had a traumatic chondral fracture. All patients underwent arthroscopic repair of a discrete osteochondral lesion involving the femoral condyle with a bioabsorbable fixation implant. All patients were evaluated at a mean of 33 months postoperatively. All patients had preoperative magnetic resonance imaging (MRI) documenting the integrity and location of the fragment. Patients were evaluated at follow-up with a physical examination, Lysholm questionnaire, and repeated MRI with specific cartilage pulse sequencing. RESULTS: At surgery, the mean size of the fragment was 2 x 2 cm. A mean of 4 nails was used in each case (range, 2 to 10). All patients were treated with a postoperative rehabilitation protocol of non-weight-bearing for a minimum of 6 weeks. The mean postoperative Lysholm score was 94 (range, 78 to 100). The outcomes were excellent in 7 patients, good in 1, and fair in 1. After surgery, MRI evaluation of the osteochondral lesion and overlying cartilage was graded as healed in 7 patients and of questionable integrity in 2. CONCLUSIONS: This report documents the efficacy of a bioabsorbable nail to internally fix osteochondral lesions. It supports the use of MRI for both preoperative planning and postoperative assessment of fragment healing. LEVEL OF EVIDENCE: Level IV, therapeutic case series.
Authors: M Abouassaly; D Peterson; L Salci; F Farrokhyar; J D'Souza; M Bhandari; O R Ayeni Journal: Knee Surg Sports Traumatol Arthrosc Date: 2013-05-17 Impact factor: 4.342
Authors: Diederick B Wouters; Joost S de Graaf; Patrick H Hemmer; Johannes G M Burgerhof; William L M Kramer Journal: Knee Surg Sports Traumatol Arthrosc Date: 2010-12-11 Impact factor: 4.342
Authors: Diederick B Wouters; Johannes G M Burgerhof; Jeff T M de Hosson; Rudolf R M Bos Journal: Knee Surg Sports Traumatol Arthrosc Date: 2010-05-13 Impact factor: 4.342