Outcomes of osteochondral lesions of the knee repaired with a bioabsorbable device.
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.
Dines
Joshua S
JS
Sports Medicine Service, Hospital for Special Surgery, New York, New York, USA. jdinesmd@gmail.com
Fealy
Stephen
S
Potter
Hollis G
HG
Warren
Russell F
RF
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
D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide)