title: Outcomes of osteochondral lesions of the knee repaired with a bioabsorbable device.
abstract: OBJECTIVE
  We sought to evaluate the functional and radiographic outcome of osteochondral lesions involving the femoral condyle that were arthroscopically repaired via a bioabsorbable fixation device made of self-reinforced poly-L-lactic acid.
  
  
  METHODS
  A retrospective clinical and radiographic evaluation of 9 patients (8 male and 1 female) with a mean age of 18 years at the time of surgery was carried out. Of these patients, 8 were diagnosed with osteochondritis dissecans and 1 had a traumatic chondral fracture. All patients underwent arthroscopic repair of a discrete osteochondral lesion involving the femoral condyle with a bioabsorbable fixation implant. All patients were evaluated at a mean of 33 months postoperatively. All patients had preoperative magnetic resonance imaging (MRI) documenting the integrity and location of the fragment. Patients were evaluated at follow-up with a physical examination, Lysholm questionnaire, and repeated MRI with specific cartilage pulse sequencing.
  
  
  RESULTS
  At surgery, the mean size of the fragment was 2 x 2 cm. A mean of 4 nails was used in each case (range, 2 to 10). All patients were treated with a postoperative rehabilitation protocol of non-weight-bearing for a minimum of 6 weeks. The mean postoperative Lysholm score was 94 (range, 78 to 100). The outcomes were excellent in 7 patients, good in 1, and fair in 1. After surgery, MRI evaluation of the osteochondral lesion and overlying cartilage was graded as healed in 7 patients and of questionable integrity in 2.
  
  
  CONCLUSIONS
  This report documents the efficacy of a bioabsorbable nail to internally fix osteochondral lesions. It supports the use of MRI for both preoperative planning and postoperative assessment of fragment healing.
  
  
  METHODS
  Level IV, therapeutic case series.
authors.affiliation: Sports Medicine Service, Hospital for Special Surgery, New York, New York, USA. jdinesmd@gmail.com
authors.forename: Joshua S
authors.initials: JS
authors.lastname: Dines
authors.forename: Stephen
authors.initials: S
authors.lastname: Fealy
authors.forename: Hollis G
authors.initials: HG
authors.lastname: Potter
authors.forename: Russell F
authors.initials: RF
authors.lastname: Warren
mesh_terms: D020341:Absorbable Implants; D000293:Adolescent; D001182:Arthroscopy; D001858:Bone Nails; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery; D050724:Fractures, Cartilage / Q000601:surgery*; D006801:Humans; D016268:Internal Fixators; D019344:Lactic Acid; D008297:Male; D010008:Osteochondritis Dissecans / Q000601:surgery*; D011091:Polyesters; D011108:Polymers; D011859:Radiography; D020127:Recovery of Function; D016896:Treatment Outcome
chemical_list: D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide)