Internal fixation for osteochondritis dissecans lesions of the knee in patients with physeal closure

Özet

Objective: The aim of this study was to present mid-term functional and radiological outcomes of patients with physeal closurewho underwent arthroscopic or open internal fixation with headless cannulated compressive screws due to unstableOsteochondritis Dissecans (OCD) lesions of the knee.Methods: With a diagnosis of unstable OCD of the knee, ten consecutive patients (seven male, three female) with physeal closure(mean age: 23 years; range: 17–40), underwent arthroscopic or open internal fixation with headless cannulated compressivescrews. The patients were retrospectively reviewed based on functional and radiological data, with a mean follow-up of 42months (range: 27–61). The average size of the defects was 4.2 cm2 with a range from 1.7 to 8 cm2 . The study protocol consisted ofthe Range of Motion (ROM), Tegner–Lysholm Score, Modified Cincinnati Rating System Questionnaire, Short Form-12 (SF-12)in addition to the plain radiograph and Computed Tomography (CT). Any development of arthrosis was assessed at the finalfollow-up according to the Internation Knee Documention Committee score (IKDC).Results: At the final follow-up, control plain radiographs and CT showed complete union of the fragments in nine patients;however, CT imaging illustrated nonunion of the fragment in one patient. The main Tegner−Lysholm Score increased from 59(range: 11–63) preoperatively to 97 (range: 88–100) at the final follow-up. Modified Cincinnati Rating System Questionnaire andIKDC score were 97 (range: 93–100) and 96 (range: 92–100), respectively, at the final follow-up. In addition, in terms of SF-12, themean physical component score was 47.5 (range: 42–49), and the mean mental component score was 57.25 (range: 48–63).Conclusion: In patients with physeal closure, internal fixation using cannulated compressive screws may be an influentialprocedure for the OCD lesions of the knee ranging in size from medium to large.Level of Evidence: Level IV, Therapeutic Study