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Comparison of Bioabsorbable Pins and Nails in the Fixation of Adult Osteochondritis Dissecans Fragments of the Knee

An Outcome of 30 Knees

Maria Weckström, MD^*,,, Mickael Parviainen, MD^,, Martti J. Kiuru, MD, PhD, Ville M. Mattila, MD, PhD and Harri K. Pihlajamäki, MD, PhD^,

From the Centre for Military Medicine, Helsinki, Finland, and the Department of Orthopaedic Surgery, Central Military Hospital, Helsinki, Finland

^* Address correspondence to Maria Weckström, MD, Centre for Military Medicine, PO Box 50, FIN-00301 Helsinki, Finland (e-mail: maria.weckstrom{at}mil.fi).

Background: The optimal device for the fixation of osteochondritis dissecans fragments of the knee remains controversial and lacks long-term results.

Purpose: To review a group of young adults with osteochondritis dissecans of the knee treated with arthroscopic fixation of the fragment using bioabsorbable pins and nails and to examine the medium-term outcome of the fixation via magnetic resonance imaging and clinical evaluation.

Study Design: Cohort study; Level of evidence, 3.

Methods: Twenty-eight patients (30 knees) with osteochondritis dissecans of the knee were treated with arthroscopic fixation using bioabsorbable, self-reinforced poly-L-lactide pins and nails. All patients were young adult males with closed physes. The average follow-up time was 5.4 years (range, 3–12). At follow-up, magnetic resonance imaging studies were used to evaluate subchondral bone healing, and the outcome was evaluated by the Kujala score.

Results: The functional results were excellent or good for 73% of the patients in the nail group versus 35% in the pin group. The lesions treated were large, with an average size of 447 mm², affecting the weightbearing area in the majority of the patients. On magnetic resonance imaging, incomplete bone consolidation was predominant in the pin group.

Conclusions: Arthroscopic fixation with bioabsorbable nails seems to be a suitable method of repair for osteochondritis dissecans of the adult knee and appears to be superior to arthroscopic fixation with bioabsorbable pins.

Key Words: osteochondritis dissecans • fixation • bioabsorbable • poly-L-lactide • magnetic resonance imaging

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				S. A. Hanna, W. J. S. Aston, P. D. Gikas, and T. W. R. Briggs Bicondylar osteochondritis dissecans in the knee: A REPORT OF TWO CASES J Bone Joint Surg Br, February 1, 2008; 90-B(2): 232 - 235. [Abstract] [Full Text] [PDF]