title: Surgical management of osteochondritis dissecans of the knee in the paediatric population: a systematic review addressing surgical techniques.
abstract: OBJECTIVE
  Several case series have been published exploring a variety of surgical treatments for osteochondritis dissecans (OCD) in patients 18 years and younger, but a systematic review is currently lacking. This systemic review identifies the various surgical techniques reported in the literature for treating OCD and assesses the effectiveness of these treatments based on functional outcomes and radiographic healing.
  
  
  METHODS
  A search of the EMBASE and MEDLINE databases was performed to identify clinical studies reporting outcomes of surgical management of OCD in the knee. A quality assessment of the included articles was conducted independently by 2 reviewers using a quality assessment tool developed by Yang et al.
  
  
  RESULTS
  A total of 25 papers including 470 patients aged ≤18 years (516 lesions) met the eligibility criteria and were reviewed. Surgical techniques for stable lesions included (arthroscopic and open) transarticular drilling, either alone (41%) or with bioabsorbable pin fixation (3%), extra-articular drilling (29%) and fixation with bioabsorbable screws (4%) or bone pegs (4%). For unstable lesions, surgical techniques included (arthroscopic and open) fixation with bioabsorbable pins (9%), metal screws (4%), bone pegs (4 %), osteochondral plugs (3%) or bioabsorbable screws (2%), as well as transarticular drilling with bioabsorbable pin fixation (3%) and drilling with metal screw fixation (2%).
  
  
  CONCLUSIONS
  The most common techniques were transarticular drilling for stable lesions and bioabsorbable pin fixation for unstable lesions. The key findings were that the vast majority of lesions healed postoperatively, regardless of technique, and that high-quality trials are required to more appropriately compare the effectiveness of techniques.
  
  
  METHODS
  Systematic review, Level IV.
authors.affiliation: Division of Orthopaedic Surgery, Department of Surgery, McMaster University Medical Center, 1200 Main St. West, Room 4E17, Hamilton, ON, L8N 3Z5, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Abouassaly
authors.forename: D
authors.initials: D
authors.lastname: Peterson
authors.forename: L
authors.initials: L
authors.lastname: Salci
authors.forename: F
authors.initials: F
authors.lastname: Farrokhyar
authors.forename: J
authors.initials: J
authors.lastname: D'Souza
authors.forename: M
authors.initials: M
authors.lastname: Bhandari
authors.forename: O R
authors.initials: OR
authors.lastname: Ayeni
mesh_terms: D000293:Adolescent; D002648:Child; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D019637:Orthopedic Procedures / Q000295:instrumentation*; D010008:Osteochondritis Dissecans / Q000601:surgery*; D014945:Wound Healing