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Summary
Surgical management of osteochondritis dissecans of the knee is indicated when the
ununited fragment remains persistently ununited and the knee becomes symptomatic and
does not respond to conservative measures of rest and immobilization. Traditionally,
arthrotomy was done and either bone peg grafts, with or without fixation, or excision
of the fragment and drilling of the base of the crater were performed. This paper
presents a series of 29 patients who were treated surgically for symptomatic osteochondritis
dissecans using arthroscopic techniques. In this series of patients, excision of fragment
and drilling or abrasion of the crater were done. In the instances when the fragment
had become a loose body, the loose body was simply excised and the crater was then
either drilled or left alone. The plan of this study is to follow up these patients
for a long time to determine the ultimate result. To our knowledge, this paper is
the first report of the early results of this form of surgery in the treatment of
this difficult lesion of the knee. The early follow-up indicates a 72% satisfactory
result rate when both subjective and objective means of measuring the results are
considered. An interesting finding during the study was the high incidence of significant
intra-articular pathology (51%) other than the osteochondritis discovered when arthroscopic
techniques are used. There were no complications from the arthroscopic surgery.
Key Words
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Copyright
© 1988 Arthroscopy Association of North America. All rights reserved. Published by Elsevier Inc.
