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Surgical Management Of Osteochondritis Dissecans Of The Patellofemoral Joint

Surgical Management Of Osteochondritis Dissecans Of The Patellofemoral Joint

Ryo Kanto, MD, JAPAN Tomoya Iseki, MD, PhD, JAPAN Hiroshi Nakayama, MD., Ph.D., JAPAN Shintaro Onishi, MD, PhD, JAPAN Yoshitaka Nakao, MD, JAPAN Shota Morimoto, MD, PhD, JAPAN Shinichi Yoshiya, MD, JAPAN Toshiya Tachibana, MD, PhD, JAPAN

Hyogo Medical University, Nishinomiya, Hyogo, JAPAN


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Anatomic Location

Anatomic Structure

Treatment / Technique

Sports Medicine


Summary: A total of 13 lesions were identified in 11 patients with the mean age at the surgery of 14.5 years. All patients return to preinjury level of sports activity with the mean period of 4.5 months after surgery. Surgical treatment of patellofemoral OCD produces a high rate of satisfaction and return to sports at short-term follow-up.


Background

Osteochondritis dissecans (OCD) lesions arising in the patellofemoral joint are rarely described, and treatment plans are not well delineated.

Purpose

To evaluate the clinical characteristics and outcomes of patients who undergo surgery for OCD lesions of the patellofemoral joint.

Methods

This is a retrospective case series of patients who underwent surgery for patellofemoral OCD. Characteristic features, surgical procedures, and treatment outcomes were extracted from medical records.

Results

A total of 13 lesions were identified in 11 patients (11 males) with the mean age at the surgery of 14.5 years (range, 8-32 years). 10 lesions (76.9%) were located on the lateral trochlea and 3 lesions (23.1%) were located on the patella. The International Cartilage Repair Society (ICRS) classification in arthroscopic findings was grade I in 3 patients, grade II in 2 patient, grade III in 1 patient, and grade IV in 7 patients. 7 knees underwent loose body removal with marrow stimulation, 5 knees underwent transarticular drilling, and 1 knee underwent fixation with bioabsorbable pins. The average length of follow-up was 29.9 months. Radiographic healing was achieved in all patients at an average of 4.9 months after drilling (range, 3 to 8 months). All patients return to preinjury level of sports activity with the mean period of 4.5 months after surgery. At the final follow-up, the Lysholm score improved from 74.5 ± 12.0 to 97.6 ± 3.7 points.

Conclusion

Surgical treatment of patellofemoral OCD produces a high rate of satisfaction and return to sports at short-term follow-up.


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