title: Results of arthroscopic fixation of osteochondritis dissecans lesion of the knee with cylindrical autogenous osteochondral plugs.
abstract: BACKGROUND
  In situ fixation of unstable lesions of osteochondral dissecans of the knees with cylindrical osteochondral autograft transplantation has been reported to provide excellent results with healing of the osteochondral dissecans fragment.
  
  
  OBJECTIVE
  To evaluate the clinical results and magnetic resonance imaging findings of the osteochondral dissecans of knees treated with in situ fixation of the osteochondral fragments with osteochondral autograft transplantation.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  Twelve knees (12 patients; mean age, 16.0 years) with osteochondral dissecans lesions were treated with in situ fixation with autogenous osteochondral plugs. The mean lesion size was 2.4 cm(2) (range, 1.0-4.9 cm(2)). The osteochondral dissecans lesions were located on the medial femoral condyle in 10 patients and on the lateral femoral condyle in 2 patients. Seven lesions were located in the weightbearing area. The International Cartilage Repair Society classification in arthroscopic findings was grade II in 1 patient, grade III in 8 patients, and grade IV in 3 patients. All patients were evaluated with the Hughston Rating Scale form with the mean follow-up at 4.5 years (range, 2.8-5.9 years). The interface between the osteochondral fragment and subchondral bone and changes in donor site of the osteochondral graft were evaluated with T2-weighted magnetic resonance image up to 12 months postoperatively.
  
  
  RESULTS
  The Hughston Rating Scale scored 8 knees as excellent, 3 as good, and 1 as fair. The interface between the osteochondral fragment and subchondral bone had disappeared on magnetic resonance image by 3 months postoperatively in all cases. No complications arising from the donor site area were observed. Signal intensity of donor site changed from high signal preoperatively to homogeneous surrounding cancellous bone by 1 year postoperatively.
  
  
  CONCLUSIONS
  Biological fixation of the osteochondral dissecans lesion with cylindrical osteochondral autograft provided healing of the osteochondral fragments.
authors.affiliation: Department of Orthopaedic Surgery, Hirosaki University, School of Medicine, 5 Zaifucho, Hirosaki 036-8562, Japan. kazu3miura@aol.com
authors.forename: Kazutomo
authors.initials: K
authors.lastname: Miura
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Ishibashi
authors.forename: Eiichi
authors.initials: E
authors.lastname: Tsuda
authors.forename: Hideki
authors.initials: H
authors.lastname: Sato
authors.forename: Satoshi
authors.initials: S
authors.lastname: Toh
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D016025:Bone Transplantation / Q000379:methods*; D002358:Cartilage, Articular / Q000637:transplantation*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint; D008279:Magnetic Resonance Imaging; D008297:Male; D010008:Osteochondritis Dissecans / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome