Healing Osteochondral Dissecans with Bone PlugsIn this study, 12 knees with osteochondritis dissecans (OCD) were treated with surgery. OCD is a condition in which a piece of cartilage separates from the bone taking a fragment of bone with it.
OCD occurs most often in young athletes. Boys and girls are both affected. OCD is treated first with conservative or nonoperative care. Nonoperative care includes protected weight bearing and activity modification for at least three months.
When pain persists and activities are limited, surgery may be needed. Surgery is done to enhance the healing process of the osteochondral fragment. In this study, the surgical procedure used plugs of bone harvested from the patient to hold the unstable fragment of bone in place.
This operation is called an osteochondral autograft transfer or OAT. The specific OAT technique used here is called in situ fixation. It means the fragment is fixed or held in place where it separated from the bone. Holes are drilled and the harvested bone plug fits like a peg through the fragment into the bone beneath it.
All patients had six weeks of rehab with a gradual return to athletic activity. High-impact sports such as basketball and gymnastics were not allowed for the first three months. A series of MRIs were taken to show the progress of healing bone. Everyone was followed at least two years. Some patients were seen for up to five years.
Knee symptoms were improved in all patients after the stabilization operation. There were no problems at the donor site. The MRIs showed healed knees for all patients by the end of three months. This is the earliest healing time reported. Other surgical treatment methods take five to eight months to heal.
Kazutomo Miura, MD, et al. Results of Arthroscopic Fixation of Osteochrondritis Dissecans Lesion of the Knee with Cylindrical Autogenous Osteochondral Plugs. In The American Journal of Sports Medicine. February 2007. Vol. 35. No. 2. Pp. 216-222.
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