Technologies for stimulation of the reparative processes in children with knee osteochondritis dissecans: A review

Abstract

Dissecting osteochondritis of the knee joint, Koenigs disease is a disease of the knee joint that result in articular surface and osteoarthritis congruence. The disease incidence reaches 15% in the pathological knee joint structure in children. The comparative effectiveness of various treatment methods for children with Koenigs disease, from conservative therapy to orthobiological technologies, is a topical subject of discussion among specialists.
 The effectiveness of modern treatment methods for children with Koenigs disease has been evaluated and is the leading trend in the use of biotechnology for further experimental and clinical studies.
 The literature search was conducted in the electronic databases of PubMed, Web of Science, Scopus, MEDLINE, eLibrary, RSCI, and Cyberleninka, whereas 2300 references were analyzed, 283 articles were viewed, and 90 publications on orthopedics and biotechnology were selected for the review.
 Indications for conservative treatment in children with Koenigs disease are currently limited to stages III of the process. Surgical methods occupy a dominant position when pain relief and pathological focus regeneration stimulation are necessary. However, the long-term results of therapy indicate the replacement of the necrosis zone with coarse fibrous connective tissue, which is significantly inferior to hyaline cartilage in terms of biomechanical characteristics, which determines a high risk of developing osteoarthritis. The actively developing direction of orthobiology allows the use of a patients tissues to activate the processes of reparative regeneration with the relief of clinical manifestations and favorable immediate results.
 The focus of attention of researchers has shifted to the plane of orthobiological technologies following the established trends in regenerative medicine development, which provide a high proportion of favorable immediate interventional results. However, the limited number of publications and the lack of long-term results of therapy do not meet the criteria for demonstrative effectiveness of technologies.