Bioabsorbable Unsintered Hydroxyapatite/Poly-l-Lactic Acid Pin Fixation of Osteochondritis Dissecans in Adolescents: Initial Experiences

Abstract

Background This study sought to retrospectively evaluate the clinical and magnetic resonance imaging (MRI) outcomes of u-HA/PLLA pin (u-HA/PLLA: hydroxyapatite/poly-L-lactic acid) pin fixation of unstable osteochondritis dissecans (OCD) lesions of the knee.

Methods Seven adolescent patients (four females and three males) with arthroscopically unstable OCD lesions of the knee were included. The mean age at diagnosis was 13.1 years. Clinical results were evaluated preoperatively and during follow-up using the Ogilvie-Harris score (0 – 15 points). MRI scans were performed preoperatively and during follow-up, with results evaluated using the Dipaola classification (grades 1 – 4). Mean follow-up time was 29 months.

Results The median Ogilvie-Harris score improved from 13 points (range: 10 – 14 points) to 15 points (range: 13 – 15 points). Separately, the median Dipaola score improved from 3 points (range: 2 – 4 points) to 1 point (range: 1 – 4 points). No complications such as infection, synovitis, or intra-articular adhesion were observed.

Conclusions Initial experiences using bioabsorbable u-HA/PLLA pins for the refixation of unstable OCD lesions in adolescents in the knee are promising, and MRI provides excellent monitoring of healing.

Zusammenfassung

Hintergrund Retrospektive klinische und MRT-basierte (MRT: Magnetresonanztomografie) Auswertung einer ersten Fallserie von mittels bioabsorbierbaren u-HA/PLLA-Pins (u-HA/PLLA: ungesintertes Hydroxylapatit/Poly-L-Laktat) fixierten instabilen Osteochondrosis dissecans (OCD)-Läsionen des Kniegelenkes.

Methode Eingeschlossen wurden sieben Jugendliche (vier weiblich, drei männlich) mit arthroskopisch instabilen OCD-Läsionen des Kniegelenkes. Das mittlere Alter bei Diagnose betrug 13,1 Jahre. Die Auswertung erfolgte präoperativ und im Follow-up über durchschnittlich 29 Monate, jeweils klinisch mit dem Ogilvie-Harris Score (0 – 15 Punkte) bzw. mittels MRT-Untersuchungen und dem Dipaola Score (Grad 1 – 4).

Resultate Der mediane Ogilvie-Harris-Score verbesserte sich von 13 Punkten (Range: 10 – 14 Punkte) auf 15 Punkte (Range: 13 – 15 Punkte). Der mediane Dipaola Score verbesserte sich von 3 Punkten (Range: 2 – 4 Punkte) auf 1 Punkt (Range: 1 – 4 Punkte). Es wurden keine Komplikationen wie Infektionen, Synovitis oder intraartikuläre Adhäsionen festgestellt.

Zusammenfassung Erste Erfahrungen mit bioabsorbierbaren u-HA/PLLA-Pins in der Refixierung von instabilen OCD-Läsionen im Knie sind vielversprechend. Das MRT erlaubt eine hervorragende Beurteilung des Heilungsverlaufes.

Key words

Osteochondritis dissecans - juvenile - u-HA/PLLA - bioabsorbable pins

Schlüsselwörter

Osteochondrosis dissecans - juvenil - u-HA/PLLA - bioabsorbierbare Pins

Publication History

Article published online:
24 November 2020

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