title: Transarticular drilling for stable juvenile osteochondritis dissecans of the medial femoral condyle.
abstract: OBJECTIVE
  Drilling is the most common operative treatment for stable juvenile osteochondritis dissecans (OCD) of the knee. However, prognostic factors remain unclear because of lack of precise radiographic and histopathologic investigations. The purpose of this study was to evaluate the clinical results and prognostic factor of the arthroscopic drilling for juvenile OCD lesions at the medial femoral condyle (MFC), using computed tomography (CT) images.
  
  
  METHODS
  Eighteen skeletally immature patients (boys, n = 16; girls, n = 2, mean age, 12 years) underwent arthroscopic antegrade transarticular drilling for a total of 19 OCD lesions of MFC. Functional outcomes were evaluated with the Lysholm score at follow-up (mean, 30 months). Preoperative osteochondral condition and postoperative healing were evaluated by CT images.
  
  
  RESULTS
  All 18 patients returned to their previous level of sports activity and showed excellent functional outcomes (mean Lysholm score, 77.2 ± 9.4 preoperative vs. 99.5 ± 1.6 postoperative). There were 10 osteochondral lesions and 9 subchondral bone defect lesions under preoperative CT examination. Postoperatively, 15 of 19 lesions healed completely at a mean of 6 months; however, the remaining four lesions (all osteochondral types) did not achieve complete radiographic healing after 2 years.
  
  
  CONCLUSIONS
  Transarticular drilling for stable juvenile OCD produced excellent functional outcomes. However, the osteochondral type may influence radiographic outcome.
  
  
  METHODS
  Case series, Level IV.
authors.affiliation: Department of Sports Orthopaedics, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8025, Japan. yonechan-osk@umin.ac.jp
authors.forename: Yasukazu
authors.initials: Y
authors.lastname: Yonetani
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Shiozaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanamoto
authors.forename: Masashi
authors.initials: M
authors.lastname: Kusano
authors.forename: Akira
authors.initials: A
authors.lastname: Tsujii
authors.forename: Shuji
authors.initials: S
authors.lastname: Horibe
mesh_terms: D000293:Adolescent; D001182:Arthroscopy / Q000379:methods*; D002648:Child; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D010008:Osteochondritis Dissecans / Q000000981:diagnostic imaging / Q000601:surgery*; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
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