Document Type: RESEARCH PAPER

Authors

1 Orthopedic Department, Shahid Beheshti University of Medical Sciences, Akhtar Hospital, Tehran, Iran

2 Orthopedic Department, Guilan University of Medical Sciences, Rasht, Iran

3 professor of orthopaedic surgery, Department of Orthopaedics and Traumatology. University Ghent, Ghent, Belgium.

4 Akhtar Orthopedic Training and Research Hospital, Shahid Beheshti University of medical Sciences, Tehran, Iran

Abstract

Purpose: Although some surgical techniques have been described for the operative treatment of unstable Osteochondritis dissecans (OCD) of the knee, outcomes are variable and aren’t satisfying totally. The aim of the present study is to evaluate the outcomes of autogenous osteochondral grafting for OCD of the knee.
Methods: In a case series study, from June 2014 to July 2015, 16 patients with stage II-IV OCD (International Cartilage Repair Society (ICRS)) of the femoral condyle were investigated. Surgical intervention considered in cases of stage III (4 cases) and IV (2 cases) and in stage II (10 cases) ones that were nonresponsive to conservative treatment. At the initial and final visits, the IKDC, Lysholm score and Tegner activity scale were evaluated.
Results: The mean preoperative IKDC score (53.4) increased significantly following surgery (84.3) (P < 0.001). Based on the IKDC grading system, before the operation, the knee status was graded as nearly normal, abnormal, and severely abnormal in 4, 10, and 2 patients, respectively. At final post-surgical follow up, 15 normal and 1 abnormal knee were documented (P < 0.001). At the final visit, all of the patients (except one) were asymptomatic and returned to their previous activity levels.
Conclusion: Surgical treatment of unstable OCD using autogenous osteochondral graft shows successful outcomes. In addition to reliable fixation, it can enhance healing and convert an uncontained lesion to contained one with healthy cartilage.

Keywords