Update in the treatment of osteochondritis dissecans.
During the early part of this century, various treatments for osteochondritis dissecans were recommended. A conservative program consisting of immobilization and non-weightbearing was advocated by many surgeons, particularly for children under 1 5 years of age. Later, fragments were pinned or removed in children's knees, while various methods of bone grafting were suggested for the adult.With the development of arthroscopic surgery in the 1970s, these methods were reevaluated. Various treatments were suggested, including drilling, drilling and pinning, reconstruction of craters, replacement of lesions, and methods of grafting. Although conservative management is still indicated for some patients, arthrotomy may be necessary under certain conditions.In the early 1980s scintigraphy has become helpful in following cases treated conservatively, as well as identifying those that require surgery. Also, methods of electrical stimulation are being applied and their results are being evaluated. The concept of early motion has gained more attention. Over a period of nine years, 1975 to 1984, arthroscopic surgery has been further modified. With this in mind, an update of all methods is here recorded and presented for consideration.
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Guhl