Bioabsorbable Screw Fixation Provides Good Results With Low Failure Rates at Mid-term Follow-up of Stable Osteochondritis Dissecans Lesions That Do Not Improve With Initial Conservative Treatment
Purpose: To evaluate the clinical and radiographic outcomes of patients who have undergone bioabsorbable screw fixation for intact, stable grade I and II osteochondritis dissecans (OCD) lesions for which at least 6 months of conservative management has failed. Methods: A retrospective review of pros...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-04-01
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| Series: | Arthroscopy, Sports Medicine, and Rehabilitation |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666061X23002146 |
| _version_ | 1797315979117592576 |
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| author | Ryan Quigley, M.D. Sachin Allahabadi, M.D. Allen A. Yazdi, B.S. Landon P. Frazier, B.S. Katie J. McMorrow, B.S. Zachary D. Meeker, B.S. Kyle R. Wagner, M.D. Jimmy Chan, M.D. Brian J. Cole, M.D., M.B.A. |
| author_facet | Ryan Quigley, M.D. Sachin Allahabadi, M.D. Allen A. Yazdi, B.S. Landon P. Frazier, B.S. Katie J. McMorrow, B.S. Zachary D. Meeker, B.S. Kyle R. Wagner, M.D. Jimmy Chan, M.D. Brian J. Cole, M.D., M.B.A. |
| author_sort | Ryan Quigley, M.D. |
| collection | DOAJ |
| description | Purpose: To evaluate the clinical and radiographic outcomes of patients who have undergone bioabsorbable screw fixation for intact, stable grade I and II osteochondritis dissecans (OCD) lesions for which at least 6 months of conservative management has failed. Methods: A retrospective review of prospectively collected data from a single institution was performed to identify patients who underwent internal fixation of stable grade I and II OCD lesions (according to the Guhl classification) between January 2010 and January 2020. Patients were included regardless of the presence of concomitant procedures. The inclusion criteria consisted of (1) primary surgery, (2) failure of at least 6 months of conservative management, (3) the use of a bioabsorbable screw (or screws), and (4) minimum 2-year clinical follow-up. Radiographs were obtained at a minimum of 1 year postoperatively. Patient demographic characteristics, clinical patient-reported outcomes, complications, and failure rates were noted. Results: Twenty-four knees among 23 patients (96% follow-up) were analyzed and followed up for 6.36 ± 3.42 years (range, 2.0-12.7 years). Patients showed statistically significant postoperative improvements in all patient-reported outcomes including the Lysholm score, International Knee Documentation Committee score, and Knee Injury and Osteoarthritis Outcome Score subscales (P < .05). In 3 knees (12%), a reoperation was required due to failure at an average of 3.64 years after the index procedure. No specific complications were attributed to the use of bioabsorbable screws. Patients in whom primary surgical treatment failed did not differ in demographic characteristics, arthroscopic findings, or surgical treatment from those who had successful treatment. Conclusions: Internal fixation of stable grade I and II OCD lesions with bioabsorbable screws produces reliable results with a 12% rate of failure in appropriately indicated patients in whom at least 6 months of conservative management has failed. Clinical outcomes improved significantly during the mid-term follow-up period. Level of Evidence: Level IV, therapeutic case series. |
| first_indexed | 2024-03-08T03:12:38Z |
| format | Article |
| id | doaj.art-53144dcc46744816bf11339039baa567 |
| institution | Directory Open Access Journal |
| issn | 2666-061X |
| language | English |
| last_indexed | 2024-03-08T03:12:38Z |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroscopy, Sports Medicine, and Rehabilitation |
| spelling | doaj.art-53144dcc46744816bf11339039baa5672024-02-13T04:07:18ZengElsevierArthroscopy, Sports Medicine, and Rehabilitation2666-061X2024-04-0162100863Bioabsorbable Screw Fixation Provides Good Results With Low Failure Rates at Mid-term Follow-up of Stable Osteochondritis Dissecans Lesions That Do Not Improve With Initial Conservative TreatmentRyan Quigley, M.D.0Sachin Allahabadi, M.D.1Allen A. Yazdi, B.S.2Landon P. Frazier, B.S.3Katie J. McMorrow, B.S.4Zachary D. Meeker, B.S.5Kyle R. Wagner, M.D.6Jimmy Chan, M.D.7Brian J. Cole, M.D., M.B.A.8Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A.Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A.Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A.Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A.Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A.Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A.Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A.Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A.Address correspondence to Brian J. Cole, M.D., M.B.A., Rush University Medical Center, 1611 W Harrison St, Ste 300, Chicago, IL 60612, U.S.A.; Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A.Purpose: To evaluate the clinical and radiographic outcomes of patients who have undergone bioabsorbable screw fixation for intact, stable grade I and II osteochondritis dissecans (OCD) lesions for which at least 6 months of conservative management has failed. Methods: A retrospective review of prospectively collected data from a single institution was performed to identify patients who underwent internal fixation of stable grade I and II OCD lesions (according to the Guhl classification) between January 2010 and January 2020. Patients were included regardless of the presence of concomitant procedures. The inclusion criteria consisted of (1) primary surgery, (2) failure of at least 6 months of conservative management, (3) the use of a bioabsorbable screw (or screws), and (4) minimum 2-year clinical follow-up. Radiographs were obtained at a minimum of 1 year postoperatively. Patient demographic characteristics, clinical patient-reported outcomes, complications, and failure rates were noted. Results: Twenty-four knees among 23 patients (96% follow-up) were analyzed and followed up for 6.36 ± 3.42 years (range, 2.0-12.7 years). Patients showed statistically significant postoperative improvements in all patient-reported outcomes including the Lysholm score, International Knee Documentation Committee score, and Knee Injury and Osteoarthritis Outcome Score subscales (P < .05). In 3 knees (12%), a reoperation was required due to failure at an average of 3.64 years after the index procedure. No specific complications were attributed to the use of bioabsorbable screws. Patients in whom primary surgical treatment failed did not differ in demographic characteristics, arthroscopic findings, or surgical treatment from those who had successful treatment. Conclusions: Internal fixation of stable grade I and II OCD lesions with bioabsorbable screws produces reliable results with a 12% rate of failure in appropriately indicated patients in whom at least 6 months of conservative management has failed. Clinical outcomes improved significantly during the mid-term follow-up period. Level of Evidence: Level IV, therapeutic case series.http://www.sciencedirect.com/science/article/pii/S2666061X23002146 |
| spellingShingle | Ryan Quigley, M.D. Sachin Allahabadi, M.D. Allen A. Yazdi, B.S. Landon P. Frazier, B.S. Katie J. McMorrow, B.S. Zachary D. Meeker, B.S. Kyle R. Wagner, M.D. Jimmy Chan, M.D. Brian J. Cole, M.D., M.B.A. Bioabsorbable Screw Fixation Provides Good Results With Low Failure Rates at Mid-term Follow-up of Stable Osteochondritis Dissecans Lesions That Do Not Improve With Initial Conservative Treatment Arthroscopy, Sports Medicine, and Rehabilitation |
| title | Bioabsorbable Screw Fixation Provides Good Results With Low Failure Rates at Mid-term Follow-up of Stable Osteochondritis Dissecans Lesions That Do Not Improve With Initial Conservative Treatment |
| title_full | Bioabsorbable Screw Fixation Provides Good Results With Low Failure Rates at Mid-term Follow-up of Stable Osteochondritis Dissecans Lesions That Do Not Improve With Initial Conservative Treatment |
| title_fullStr | Bioabsorbable Screw Fixation Provides Good Results With Low Failure Rates at Mid-term Follow-up of Stable Osteochondritis Dissecans Lesions That Do Not Improve With Initial Conservative Treatment |
| title_full_unstemmed | Bioabsorbable Screw Fixation Provides Good Results With Low Failure Rates at Mid-term Follow-up of Stable Osteochondritis Dissecans Lesions That Do Not Improve With Initial Conservative Treatment |
| title_short | Bioabsorbable Screw Fixation Provides Good Results With Low Failure Rates at Mid-term Follow-up of Stable Osteochondritis Dissecans Lesions That Do Not Improve With Initial Conservative Treatment |
| title_sort | bioabsorbable screw fixation provides good results with low failure rates at mid term follow up of stable osteochondritis dissecans lesions that do not improve with initial conservative treatment |
| url | http://www.sciencedirect.com/science/article/pii/S2666061X23002146 |
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