2017 ISAKOS Biennial Congress IFOSMA ePoster #5082

 

Outcome of osteochondral fractures of adolescent patients’ knees repaired totally arthroscopically with bioabsorbable fixation screws

Biao Guo, Prof, Fuyang, Anhui CHINA
Yunlei Zhai, Fuyang, Anhui CHINA

Fuyang City People Hospital, fuyang, anhui, china

FDA Status Not Applicable

Summary

Large osteochondral fractures of the knee in adolescent patients can be diagnostically and therapeutically challenging. Historically, management has involved removal of the fragment, leaving a large area of bone devoid of articular cartilage on the weight-bearing surface. This study assessed outcome osteochondral fractures of adolescent patients’ knees repaired totally arthroscopically with bioabsorbable fixation screws rods.

Abstract

Purpose

We sought to assess the functional and radiographic outcome of osteochondral fractures of adolescent patients’ knees repaired totally arthroscopically with bioabsorbable fixation screws.
Methed: 9 patients (4 male and 5 female), between twelve and seventeen years old, with osteochondral fracture of knee were treated totally arthroscopically with bioabsorbable fixation screws (Poly-L-Lactic acid). Of these patients, 1 were diagnosed with osteochondritis dissecans and 8 had a traumatic chondral fracture. Each patient was evaluated at a mean of 16 months postoperatively with a clinical assessment, during which the knee was scored according to Tegner scores and Lysholm questionnaire, plain radiographs were made, and magnetic resonance imaging scans were acquired ..
Result: At surgery, the osteochondral fragment was detached from the lateral femoral condyle in 6 and it was detached from the medial femoral condyle in 3, the mean size of the fragment was 1 * 1.5 cm, and osteochondral fractures were reducted and fixed arthroscopically. All patients were were managed with a range-of-motionbrace (0 to 60°) and toe-touch weight-bearing on crutches for six weeks. 7 patients had normal findings on knee radiographs, and 2 had radiographs that showed minor changes. CT and MRI scans of all patients demonstrated cartilage was graded as healed in 6 patients and of questionable integrity in 3. The mean postoperative Lysholm score was 88 (range, 76 to 95). The outcomes were excellent in 6 patients, good in 3, and fair in 1 according to Tegner Scores.

Conclusion

Our results documents the efficacy of a bioabsorbable screw to internally fix osteochondral lesions arthroscopically. The use of MRI and CT for both preoperative planning and postoperative assessment of fragment healing was demonstrate.