Arthroscopic repair of osteochondritis dissecans of the femoral condyles with metal staple fixation: a report of 28 cases.

摘要

In a retrospective clinical study we evaluated the outcome of arthroscopic repair of osteochondritis dissecans (OCD) of the femoral condyles with metal stable fixation. Twenty-eight knees of 26 patients (mean age 20 years) with OCD of the knee were treated by fixation of the fragments with Hoffmann's dynamic metal staples arthroscopically and by additional arthrotomy in 7 knees. At follow-up (mean 4 years, 1-7) patients were interviewed for any residual symptoms and underwent a routine clinical and radiographic examination. The clinical results were based on the grading scale of Lysholm. The 17 knees which did not require further surgery showed 13 instances of complete healing, 3 of partial healing, and 1 of nonhealing. The 11 knees which had reoperations showed 2 instances of complete healing, 5 of partial healing, and 4 nonhealing. There was no significant difference between early or late surgery, and results were not related significantly to site of the lesion, handling of the fragment and the crater, percutaneous drilling, or type of fragmentation. Clinical grading of 13 knees was as excellent, 11 good, and 4 fair. Broken stables were observed in 9 knees, and they were removed from 5 knees. Complete healing was thus achieved in one-half and partial healing in one-third of cases. The metal staples used here fit for use in the arthroscopic fixation of the OCD of the knee, although the staples had a marked liability to break.