title: Knee Osteochondritis Dissecans Treated by the AO Hook Fixation System: A Four Year Follow-Up of an Alternative Technique.
abstract: Surgical fixation is recommended for stable osteochondritis dissecans (OCD) lesions that have failed nonoperative management and for all unstable lesions. In this study we set out to describe and evaluate an alternative method of surgical fixation for such lesions. Five knees with unstable OCD lesions in four male adolescent patients with open physes were treated with the AO Hook Fixation System. The outcome was evaluated both clinically and with three separate outcome systems (IKDC 2000, KOOS, Lysholm) at one and a mean four year follow-up. We demonstrated excellent clinical results in all patients. At four years, all scoring systems demonstrated statistically significant improvement when compared to the preoperative status. Our study suggests that the AO Hook Fixation System is an alternative method of surgical intervention with comparable medium term results with other existing modes of fixation and the added biomechanical advantage of the absence of distracting forces during hardware removal.
authors: Joint Reconstruction Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP, UK ; Department of Orthopaedics and Trauma Surgery, Warrington Hospital, Lovely Lane, Cheshire, WA5 1QG, UK.
authors: Ioannis P
authors: IP
authors: Pengas
authors: Department of Orthopaedics and Trauma Surgery, Central Middlesex Hospital, Acton Lane, London, NW10 7NS, UK.
authors: Angelos
authors: A
authors: Assiotis
authors: Department of Orthopaedics and Trauma Surgery, Evelina Childrens Hospital, Guy's & St Thomas Hospital NHS Trust, Westminster Bridge Road, London, SE1 7EH, UK.
authors: Michail
authors: M
authors: Kokkinakis
authors: Joint Reconstruction Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP, UK.
authors: Wasim S
authors: WS
authors: Khan
authors: Department of Orthopaedics and Trauma Surgery, Warrington Hospital, Lovely Lane, Cheshire, WA5 1QG, UK.
authors: Paul
authors: P
authors: Meyers
authors: Department of Orthopaedics and Trauma Surgery, Heart of England NHS Foundation Trust, Bordesley Green East, Birmingham, B9 5SS, UK.
authors: James
authors: J
authors: Arbuthnot
authors: Department of Orthopaedics and Trauma Surgery, Aintree University Hospital, Liverpool, Merseyside L9 7AL, UK.
authors: Michael J
authors: MJ
authors: Mcnicholas
keywords: AO hook fixation system; knee; osteochondritis dissecans.