[Treatment of osteochondritis dissecans of the knee joint].
Osteochondritis dissecans (OD) is a lesion of the subchondral bone which can result in sequestration of the osteochondral lesion. It is categorized into 4 stages, and juvenile and adult forms depending on the distal femoral physis maturity. Prognosis and treatment depends on age and stage. Prognosis is favorable in stable lesions (stage I and II) at typical location (medial femoral condyle) in a child with open physes. Therefore non-operative treatment is indicated. If there is no response to non-operative treatment drilling to create channels for potential revascularization can be done. In unstable lesions (stage III and IV) operative treatment is necessary. Long-term results after excision of the fragment with or without drilling of the defect site are poor. Therefore refixation of an intact osteochondral fragment or biologic reconstruction should be tried.
Orthopädische Klinik, Universitätsklinikum Carl Gustav Carus, Fetscherstrasse 74, 01307 Dresden, Deutschland. Joerg.Luetzner@uniklinikum-dresden.de
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J
Lützner
J
J
Mettelsiefen
K P
KP
Günther
F
F
Thielemann
D001182:Arthroscopy / Q000379:methods*; D005858:Germany; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D010008:Osteochondritis Dissecans / Q000628:therapy*; D010027:Osteotomy / Q000379:methods*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D019651:Plastic Surgery Procedures / Q000379:methods*