Revision of Failed Osteochondritis dissecans Surgical Treatment: Case Report.

Autor:	Maiotti M; Orthopedics, Shoulder Unit Villa Stuart Clinic (Rome), Rome, Italy., Rossi V; Orthopedics, Shoulder Unit Villa Stuart Clinic (Rome), Rome, Italy., Armocida D; Human Neuroscience, University of Rome La Sapienza, Rome, Italy.
Jazyk:	angličtina
Zdroj:	Zeitschrift fur Orthopadie und Unfallchirurgie [Z Orthop Unfall] 2024 Jun; Vol. 162 (3), pp. 310-315. Date of Electronic Publication: 2023 Jan 20.
DOI:	10.1055/a-1994-0956
Abstrakt:	Background: Osteochondritis dissecans (OD) is one of the most common cartilage lesions of the knee. Conservative treatment is recommended if the lesions are stable with no loose bodies or there are open physes. Surgical intervention is recommended as the primary treatment in symptomatic adults with unstable chondral lesions or with concomitant loose bodies. Methods: We describe a case of a patient suffering from OD with a bone lesion in the weight-bearing area of medial femoral condyle. Arthroscopy was performed and an osteochondral fragment from the medial femoral condyle was observed and two articular loose bodies were removed. After months, the patient returned with pain and a locked knee. magnetic resonance imaging (MRI) presented a new unstable chondral flap at the posterior border of the previous lesion. Surgery was performed again, and at open examination, the previous OD lesions were covered by regenerative tissue, with a lesion of 3 cm 2 at the inferior medial part of the chondral flap. The peripheral margins were cleaned, and a subchondral crater was curetted. The subchondral lesion was debrided, and the flap was fixed with pins and a central bioresorbable screws. Results: Revision surgery with fixation of the chondral flap using bioresorbable pins and screws led to satisfactory results. Conclusion: Open revision surgery allowed us a more accurate assessment of the OD area to provide an effective fixation of the chondral flap and in this circumstance, this should have been done after seeing the first MRI. Competing Interests: The authors declare that they have no conflict of interest. (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu