title: Arthroscopic antegrade drilling for unstable juvenile osteochondritis dissecans of the knee: mid-term results.
abstract: OBJECTIVE
  The aim of our study was to retrospectively review the mid-term clinical and imaging outcomes of unstable knee juvenile osteochondritis dissecans (JOCD) patients treated with antegrade drilling.
  
  
  METHODS
  Knee arthroscopy and antegrade drilling was performed on 63 knee JOCD patients between 2006 and 2012. Lysholm and Tegner, as well as International Knee Documentation Committee (IKDC), scores were recorded and compared preoperatively and at the latest follow-up. Knee radiographs and magnetic resonance imaging were used to examine lesion healing status.
  
  
  RESULTS
  The mean follow-up time was 4.7 years (range 2-7.3 years), and 52 patients finished the follow-up. The average defect size was 2.79 cm(2) (range 1-4 cm(2)). Forty three patients had excellent outcomes with full return to pre-injury activities and reported no symptom recurrence or deterioration over time. The overall healing rate was 82.7 % (43/52). The average Lysholm score was improved from 51.3 to 85.8 (P = 0.001). The mean Tegner activity level was improved from 3.7 to 6.7 (P = 0.013). And the mean IKDC score was improved from 55.7 to 73.2 (P = 0.007). On average, evidence of healing was observed at 11.3 months after surgery (range 6-18 months)
  
  
  CONCLUSIONS
  Our series showed good to excellent mid-term results in unstable knee JOCD patients who were treated by antegrade drilling. This technique is minimally invasive and effective, as well as cost effective.
  
  
  METHODS
  4.
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Xu
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Hu
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China.
authors.forename: Dianming
authors.initials: D
authors.lastname: Jiang
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China. weihuang1968@126.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D001182:Arthroscopy / Q000379:methods*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D010008:Osteochondritis Dissecans / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Drilling; Juvenile; Microfracture; Osteochondritis dissecans