Skip to main content
main-content

01.06.2014 | Knee | Ausgabe 6/2014

Knee Surgery, Sports Traumatology, Arthroscopy 6/2014

Surgical management of osteochondritis dissecans of the knee in the paediatric population: a systematic review addressing surgical techniques

Zeitschrift:
Knee Surgery, Sports Traumatology, Arthroscopy > Ausgabe 6/2014
Autoren:
M. Abouassaly, D. Peterson, L. Salci, F. Farrokhyar, J. D’Souza, M. Bhandari, O. R. Ayeni

Abstract

Purpose

Several case series have been published exploring a variety of surgical treatments for osteochondritis dissecans (OCD) in patients 18 years and younger, but a systematic review is currently lacking. This systemic review identifies the various surgical techniques reported in the literature for treating OCD and assesses the effectiveness of these treatments based on functional outcomes and radiographic healing.

Methods

A search of the EMBASE and MEDLINE databases was performed to identify clinical studies reporting outcomes of surgical management of OCD in the knee. A quality assessment of the included articles was conducted independently by 2 reviewers using a quality assessment tool developed by Yang et al.

Results

A total of 25 papers including 470 patients aged ≤18 years (516 lesions) met the eligibility criteria and were reviewed. Surgical techniques for stable lesions included (arthroscopic and open) transarticular drilling, either alone (41 %) or with bioabsorbable pin fixation (3 %), extra-articular drilling (29 %) and fixation with bioabsorbable screws (4 %) or bone pegs (4 %). For unstable lesions, surgical techniques included (arthroscopic and open) fixation with bioabsorbable pins (9 %), metal screws (4 %), bone pegs (4 %), osteochondral plugs (3 %) or bioabsorbable screws (2 %), as well as transarticular drilling with bioabsorbable pin fixation (3 %) and drilling with metal screw fixation (2 %).

Conclusion

The most common techniques were transarticular drilling for stable lesions and bioabsorbable pin fixation for unstable lesions. The key findings were that the vast majority of lesions healed postoperatively, regardless of technique, and that high-quality trials are required to more appropriately compare the effectiveness of techniques.

Level of evidence

Systematic review, Level IV.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

★ PREMIUM-INHALT
e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de. Zusätzlich können Sie eine Zeitschrift Ihrer Wahl in gedruckter Form beziehen – ohne Aufpreis.

Weitere Produktempfehlungen anzeigen
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 6/2014

Knee Surgery, Sports Traumatology, Arthroscopy 6/2014 Zur Ausgabe
  1. Sie können e.Med Orthopädie & Unfallchirurgie 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Orthopädie und Unfallchirurgie und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise