title: Functional and radiographic outcome of stable juvenile osteochondritis dissecans of the knee treated with retroarticular drilling without bone grafting.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the functional and radiographic outcome of retroarticular drilling for patients with juvenile osteochondritis dissecans after 6 months of unsuccessful nonoperative treatment.
  
  
  METHODS
  A total of 20 osteochondritis dissecans lesions in 12 skeletally immature patients were treated with retroarticular drilling without bone grafting. There were 10 boys and 2 girls with a mean age of 12.0 years (range, 9 to 15 years). The functional outcomes were evaluated by use of the Lysholm score at a mean follow-up of 2.7 years after drilling, and healing of the lesions was confirmed by use of plain radiographs and magnetic resonance imaging.
  
  
  RESULTS
  The mean Lysholm score significantly improved postoperatively (from 72.3 to 95.8). All lesions except 1 healed after retroarticular drilling. Healing was achieved at a mean of 4.4 months on plain radiographs and 7.6 months on magnetic resonance imaging.
  
  
  CONCLUSIONS
  This study shows that retroarticular drilling without bone grafting leads to improved clinical outcomes and high healing rates. We advocate retroarticular drilling for patients with stable juvenile osteochondritis dissecans of the knee whose initial nonoperative treatment has failed.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan. nadachi@hiroshima-u.ac.jp
authors.forename: Nobuo
authors.initials: N
authors.lastname: Adachi
authors.forename: Masataka
authors.initials: M
authors.lastname: Deie
authors.forename: Atsuo
authors.initials: A
authors.lastname: Nakamae
authors.forename: Masakazu
authors.initials: M
authors.lastname: Ishikawa
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Motoyama
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Ochi
mesh_terms: D000293:Adolescent; D001182:Arthroscopy / Q000379:methods*; D002648:Child; D005260:Female; D005269:Femur / Q000601:surgery*; D005471:Fluoroscopy; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery; D010008:Osteochondritis Dissecans / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D015641:Radiography, Interventional; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome