Drilling techniques for osteochondritis dissecans.
Although the advanced stages of osteochondritis dissecans remain challenging to treat, most early-stage lesions in skeletally immature patients, if managed appropriately, can be stimulated to heal. For stable lesions that do not demonstrate adequate healing with nonoperative measures, such as activity modification, weight-bearing protection, or bracing, drilling of the subchondral bone has emerged as the gold standard of management. Several techniques of drilling exist, including transarticular drilling, retroarticular drilling, and notch drilling. Although each technique has been shown to be effective in small retrospective studies, higher-powered prospective comparative studies are needed to better elucidate their relative advantages and disadvantages.
Division of Sports Medicine, Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA. Electronic address: benton.heyworth@childrens.harvard.edu.
Benton E
BE
Heyworth
Division of Orthopedic Surgery, Rady Children's Hospital, 3030 Children's Way, San Diego, CA 92123, USA; Department of Orthopedic Surgery, University of California San Diego, 200 West Arbor Drive, CA 92103, USA.
Eric W
EW
Edmonds
Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Division of Orthopaedics, The Hospital for Sick Children, Toronto, Ontario, Canada.
M Lucas
ML
Murnaghan
Division of Sports Medicine, Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
Mininder S
MS
Kocher
D001182:Arthroscopy / Q000379:methods*; D005471:Fluoroscopy; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D010008:Osteochondritis Dissecans / Q000000981:diagnostic imaging / Q000601:surgery*; D014945:Wound Healing
Drilling; Knee; Osteochondritis dissecans