Abstract
We present an effective technique for retroarticular drilling and bone grafting of
juvenile osteochondritis dissecans (OCD). A radiolucent bolster is used to flex the
knee at 45°, allowing adequate C-arm visualization. A 2-cm incision is made over the
iliac spine, and soft tissue is dissected with the use of electrocautery. A 3.5-mm
Steinmann pin is driven ∼5 cm into the iliac crest. With a mallet, the 3.5-mm-long
drill sleeve from the Synthes External Fixator Set (Part #395.913; Synthes, Paoli,
PA) is tamped over and 1 cm past the guide pin, while cores of autograft cancellous
bone are harvested. The same Steinmann pin is inserted over the corresponding aspect
of the knee. The Steinmann pin is advanced to approximately 1 cm above the lesion,
and the drill guide is once again tapped over the pin. With use of the C-arm, the
pin is removed, and a 3.5-mm bit is used to drill the remaining distance into the
lesion. The graft is tamped through the drill guide and into position with the reverse
end of the bit. This technique may be repeated according to the size of the lesion.
Major advantages of this technique include the ease of harvest/transfer of autograft,
readily available instrumentation to perform the procedure, and the ability to avoid
violation of stable articular cartilage.
Key Words
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References
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Article info
Publication history
Published online: February 16, 2007
Footnotes
The authors report no conflict of interest.
Cite this article as: Lebolt JR, Wall EJ. Retroarticular drilling and bone grafting of juvenile osteochondritis dissecans of the knee. Arthroscopy 2007;23:794.e1-794.e4 [doi:10.1016/j.arthro.2006.09.007].
Identification
Copyright
© 2007 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
