Format

Send to

Choose Destination
Arthroscopy. 2014 Oct;30(10):1269-79. doi: 10.1016/j.arthro.2014.05.010. Epub 2014 Jul 18.

Meniscal suturing versus screw fixation for treatment of osteochondritis dissecans: clinical and magnetic resonance imaging results.

Author information

1
Paediatric Orthopaedic Department, University Children's Hospital Basle, Basel, Switzerland. Electronic address: carlo.camathias@ukbb.ch.
2
Orthopaedic Department, Baselland Hospital, Bruderholz, Switzerland.
3
Paediatric Orthopaedic Department, University Children's Hospital Basle, Basel, Switzerland; Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A.
4
Paediatric Orthopaedic Department, University Children's Hospital Basle, Basel, Switzerland.
5
Royal Hospital for Sick Children, Edinburgh, Scotland.

Abstract

PURPOSE:

The purpose of this study was to compare meniscal stabilization alone with screw fixation in restoring subjective and objective knee function and structural cartilage integrity in skeletally immature patients with osteochondritis dissecans (OCD) of the knee.

METHODS:

This study comprised 28 patients (32 knees) with magnetic resonance imaging (MRI)-confirmed OCD. Unstable menisci were treated with either stabilization (15 patients, 16 knees) or screw fixation (13 patients, 16 knees; control group). Patients were assessed by functional scoring (Hughston, International Knee Documentation Committee [IKDC]) and MRI for a minimum follow-up period of 2.5 years.

RESULTS:

In the meniscus stabilization group, the Hughston score improved from 1.4 to 3.8 (P < .01). There was improvement in the IKDC grade, from grade C preoperatively to grade A in 14 knees and grade B in 2 (P < .01). Of 16 knees, 15 had complete defect resolution on MRI by 1 year. There were 3 complications: 1 wound infection, 1 case of trauma requiring reoperation, and 1 revision because of treatment failure at 6 months. In the screw fixation group, the Hughston score improved from 1.4 to 3.6 (P < .01). There was a significant improvement in IKDC grade, from grade C preoperatively to grade A in 11 knees and grade B in 5 (P < .01). At 2 years postoperatively, no differences in these variables were found between the groups.

CONCLUSIONS:

Meniscal suturing alone for the treatment of an OCD of the knee shows good or excellent results in terms of clinical scoring and MRI assessment at almost 3 years' follow-up. The results are comparable with those of screw fixation but with a faster recovery in the postoperative course.

LEVEL OF EVIDENCE:

Level III, retrospective comparative study.

PMID:
25042131
DOI:
10.1016/j.arthro.2014.05.010
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center