Osteochondral grafting for failed knee osteochondritis dissecans repairs.

Autor: Stone KR; The Stone Clinic, San Francisco, CA, USA; Stone Research Foundation, San Francisco, CA, USA., Pelsis JR; Stone Research Foundation, San Francisco, CA, USA., Crues JV 3rd; Radnet, Los Angeles, CA, USA., Walgenbach AW; The Stone Clinic, San Francisco, CA, USA; Stone Research Foundation, San Francisco, CA, USA., Turek TJ; Stone Research Foundation, San Francisco, CA, USA.
Jazyk: angličtina
Zdroj: The Knee [Knee] 2014 Dec; Vol. 21 (6), pp. 1145-50. Date of Electronic Publication: 2014 Oct 14.
DOI: 10.1016/j.knee.2014.09.003
Abstrakt: Background: Revision of failed surgical treatments of osteochondritis dissecans (OCD) lesions remains a challenge without an obvious solution. The aim of this study was to evaluate seven consecutive patients undergoing osteochondral grafting of a failed OCD repair.
Methods: The mean time from surgery to the latest evaluation was 7.0 years. IKDC, WOMAC, Tegner, and MRI studies were collected both preoperatively and during follow-up. Evaluation of the graft was assessed using the magnetic resonance observation of cartilage repair tissue (MOCART) grading system.
Results: Over the course of the study period, five patients required additional surgery with a study median of one additional surgery (range, zero to 3). At most recent follow-up, there was significant improvement from preoperative values in median IKDC (p=0.004), WOMAC (p=0.030), and Tegner (p=0.012). Complete cartilage fill and adjacent tissue integration of the paste graft were observed by MRI evaluation in five of the seven (71.4%) patients. Definitive correlation between clinical outcomes and MRI scores was not observed.
Conclusions: This study shows promising results of osteochondral grafting as a viable option for the revision of failed OCD lesion repairs; however, more patients are needed to fully support its efficacy in these challenging failed revision cases.
(Copyright © 2014 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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