Sports fitness following surgical treatment of osteochondrosis dissecans

Abstract

A retrospective analysis of 29 patients with regard to their sportive activities after operative treatment of osteochondritis dissecans was carried out. The study included 21 males and 8 females with an average age of 18 years. In 4 cases patients' history revealed a trauma. Osteochondritis dissecans was located in 16 cases in the knee joint, in 12 cases in the ankle joint and in one case in the elbow joint. In 11 cases the articular cartilage was not disrupted, and therefore subchondral focus drilling and autologous cancellous tissue grafting were a sufficient therapy. 10 out of those 11 patients had no complaints during their sportive activities 3 years after this operation. In another 10 cases with an osteochondral fragment, reimplantation was possible. 5 of those 10 patients were free of complaints during sportive activities 3 years later. In 2 of those 10 patients the reimplanted fragments did not become incorporated and had to be removed. 2 out of 8 patients with removal of necrotic fragments and curretage of subchondral bone had no complaints 3 years postoperatively. Best results could be achieved in patients with intact articular cartilage and subchondral lesion. Good results showed patients after reimplantation of the osteochondral fragment. Poor results were found in cases with necrotic osteochondral fragments. Osteochondritis dissecans with an osteochondral fragment should not be further treated conservatively but gives an urgent indication for operation. MRI is very helpful for this decision.