Luigi Adriano Pederzini1, Matteo Bartoli2, Andrea Cheli1, Fabio Nicoletta1, Gabriele Severini3. 1. Orthopeadics and Traumatology Unit, Nuovo Ospedale Civile di Sassuolo, Via Francesco Ruini 2, 41049, Sassuolo, MO, Italy. 2. Orthopeadics and Traumatology Unit, Nuovo Ospedale Civile di Sassuolo, Via Francesco Ruini 2, 41049, Sassuolo, MO, Italy. matteobartoli1@gmail.com. 3. Università Cattolica del Sacro Cuore-Fondazione Policlinico Gemelli, Largo Agostino Gemelli 8, 00168, Rome, RM, Italy.
Abstract
PURPOSE: The primary outcomes are the evaluation and quantification of pain relief and improvement in range of motion after OAT in OCD. The secondary outcomes are: resuming of sport activities, evaluation of the ADL recovery rate and subjective evaluation of the quality of life improvement. METHODS: Nine patients, affected by an unstable and non-acute OCD lesion of the capitulum humeri, have been treated by the same surgeon. The patient mean age was 22.4 (16-45 years). All subjects were treated with the same surgical technique (arthroscopic OAT from the same side knee, a single cylinder of 6.5-9 mm in diameter) and underwent the same rehabilitation. The mean follow-up was 48 months (30-52 months). The authors documented the clinical assessment of each patient and carried out a questionnaire which included the VAS scale, MEPS Score and Quick DASH score. Patients were asked for MRI and radiographs pre- and post-operatively at follow-up. RESULTS: The mean range of motion improvement was 17.9° in extension (range 13°-27°) and 10.6° in flexion (range 0°-20°) The VAS mean improvement was 7.1 (range 6-8) and the mean post-op value 0.6 (range 0-3). The MEPS score mean post-operative value was 98.3 (range 85-100). The Quick-DASH mean post-operative value was 2.5 (range 0-9.1) with a mean improvement of 41.4 points (range 36.4-47.7 points). All patients resumed sports in 6 months post-operatively. CONCLUSIONS: The autologous transplant of an osteochondral plug is a safe and promising procedure. Despite being more demanding, the arthroscopic approach is a valuable tool if the surgeon aims to reduce the invasiveness of the procedure, with all the consequent advantages. LEVEL OF EVIDENCE IV: Retrospective case series, therapeutic study.
PURPOSE: The primary outcomes are the evaluation and quantification of pain relief and improvement in range of motion after OAT in OCD. The secondary outcomes are: resuming of sport activities, evaluation of the ADL recovery rate and subjective evaluation of the quality of life improvement. METHODS: Nine patients, affected by an unstable and non-acute OCD lesion of the capitulum humeri, have been treated by the same surgeon. The patient mean age was 22.4 (16-45 years). All subjects were treated with the same surgical technique (arthroscopic OAT from the same side knee, a single cylinder of 6.5-9 mm in diameter) and underwent the same rehabilitation. The mean follow-up was 48 months (30-52 months). The authors documented the clinical assessment of each patient and carried out a questionnaire which included the VAS scale, MEPS Score and Quick DASH score. Patients were asked for MRI and radiographs pre- and post-operatively at follow-up. RESULTS: The mean range of motion improvement was 17.9° in extension (range 13°-27°) and 10.6° in flexion (range 0°-20°) The VAS mean improvement was 7.1 (range 6-8) and the mean post-op value 0.6 (range 0-3). The MEPS score mean post-operative value was 98.3 (range 85-100). The Quick-DASH mean post-operative value was 2.5 (range 0-9.1) with a mean improvement of 41.4 points (range 36.4-47.7 points). All patients resumed sports in 6 months post-operatively. CONCLUSIONS: The autologous transplant of an osteochondral plug is a safe and promising procedure. Despite being more demanding, the arthroscopic approach is a valuable tool if the surgeon aims to reduce the invasiveness of the procedure, with all the consequent advantages. LEVEL OF EVIDENCE IV: Retrospective case series, therapeutic study.
Authors: A Papen; T Schöttker-Königer; A Schäfer; F Morrison; B Hollinger; K J Burkhart; R Nietschke; A Zimmerer; N Maffulli; F Migliorini; Marco M Schneider Journal: J Orthop Surg Res Date: 2022-06-25 Impact factor: 2.677