Advertisement
Advertise here Publish your press releases here Sponsor BioPortfolio
Follow us on Twitter Sign up for daily news and research emails Contributors wanted

Drilling Juvenile Osteochondritis Dissecans: Retro- or Transarticular?

20:47 EDT 23rd April 2014 | BioPortfolio

Summary of "Drilling Juvenile Osteochondritis Dissecans: Retro- or Transarticular?"


BACKGROUND:
Early diagnosis and successful treatment of juvenile osteochondritis dissecans (JOCD) is essential in preventing articular degeneration at a young age. Surgical treatment of stable JOCD lesions failing nonoperative treatment involves retroarticular or transarticular drilling to induce revascularization and healing. Multiple case series report high healing rates and infrequent complications for both retroarticular and transarticular drilling modalities; however, it is unclear from these individual reports whether one mode of drilling provides higher healing rates. QUESTIONS/
PURPOSES:
We asked whether transarticular or retroarticular drilling of stable JOCD lesions results in differing patient-oriented outcomes, rates of radiographic healing, time to radiographic healing, and complication rates.
METHODS:
We systematically reviewed the short-term clinical outcomes of retroarticular and transarticular drilling of stable OCD lesions. PubMed and additional sources identified 65 studies; 12 studies met inclusion criteria.
RESULTS:
Heterogeneity and quality of studies limited review to qualitative analysis. No clear differences were seen in patient-oriented outcomes after treatment with either drilling modality. Radiographic healing for JOCD lesions drilled retroarticularly occurred in 96 of 111 (86%) lesions in an average of 5.6 months. Transarticular drilling of JOCD lesions resulted in 86 of 94 (91%) lesions healing by radiography in an average of 4.5 months. No complications were reported for either drilling modality.
CONCLUSIONS:
Retroarticular and transarticular drilling of stable lesions results in comparable short-term patient-oriented outcomes and radiographic healing. Further high-quality comparative studies are required to adequately compare drilling modalities, clearly define radiographic healing, and patient-oriented outcomes after nonoperative treatment.

Affiliation

Division of Orthopaedics, Department of Surgery, University of Toronto, Toronto, ON, Canada.

Journal Details

This article was published in the following journal.

Name: Clinical orthopaedics and related research
ISSN: 1528-1132
Pages:

Links

PubMed Articles [532 Associated PubMed Articles listed on BioPortfolio]

Epidemiology of hospitalised osteochondritis dissecans in young people: Incidence, geographical variation and trends over time in England from 2002 to 2010.

Osteochondritis dissecans (OCD) is an important cause of knee pain in physically active adolescents, but its aetiology remains controversial. Modern data on its epidemiology are lacking. The aim of th...

Multiple osteochondritis dissecans of knee joint in a patient with Wilson disease, focusing on magnetic resonance findings.

A 17-year-old man was admitted with a complaint of knee pain. He was diagnosed with Wilson disease by ophthalmologic and laboratory studies during hospitalization. Initial plain radiography of both kn...

Gout in a 15-year-old boy with juvenile idiopathic arthritis: a case study.

Joint pain is a common complaint in pediatrics and is most often attributed to overuse or injury. In the face of persistent, severe, or recurrent symptoms, the differential typically expands to includ...

Bilateral c1-c2 transarticular screw and c1 laminar hook fixation and bone graft fusion for reducible atlantoaxial dislocation: a seven-year analysis of outcome.

Bilateral C1-2 transarticular screw and C1 laminar hook fixation was developed on the basis of transarticular screws fixation. The modified technique has showed a better biomechanical stability than e...

Ossification defects detected in CT scans represent early osteochondrosis in the distal femur of piglets.

The purpose of the current study was to validate the use of CT for selection against osteochondrosis in pigs by calculating positive predictive value and comparing it to the positive predictive value...

Clinical Trials [103 Associated Clinical Trials listed on BioPortfolio]

Single-blind Evaluation of Device to Nail Micro-drilling in Onychomycosis

Based on manufacturer testing, no major difference in drilling condition is expected in this study compared to the drilling conditions previously established. However clinical testing is...

Pre-drilling or Self Drilling External Fixation Pins

Hypothesis There is no difference in the incidence of pin tract infection and pin loosening in case of lower extremity external fixators when self-drilling schanz pins are used with or wi...

Cartilage Autograft Implantation System (CAIS) for the Repair of Knee Cartilage Through Cartilage Regeneration

The Cartilage Autograft Implantation System (CAIS) is designed as a single surgical treatment of damaged knee cartilage using the subject's own healthy cartilage obtained from a non-weight...

A Modified (Retro-Tubercle) Opening Wedge High Tibial Osteotomy Versus the Conventional Technique

The present study was conducted among a group of Iranian patients suffering from varus knee in order to compare advantages and disadvantages of ROWHTO (Retro-Tubercle Opening Wedge High Ti...

Surgical Ovarian Drilling Versus Hormonal Treatment for Infertility Associated to PolyCystic Ovaries Syndrome (PCOS)

PolysCsytic Ovaries Syndrome (PCOS) is the most frequent endocrinopathy. The first stage of infertility treatment is Clomiphene Citrate which leads to 50 % pregnancies. In case of failure,...

Medical and Biotech [MESH] Definitions

A type of osteochondritis in which articular cartilage and associated bone becomes partially or totally detached to form joint loose bodies. Affects mainly the knee, ankle, and elbow joints.

Fibrous, bony, cartilaginous and osteocartilaginous fragments in a synovial joint. Major causes are osteochondritis dissecans, synovial chondromatosis, osteophytes, fractured articular surfaces and damaged menisci.

Inflammation of a bone and its overlaying CARTILAGE.

Rheumatoid arthritis of children occurring in three major subtypes defined by the symptoms present during the first six months following onset: systemic-onset (Still's Disease, Juvenile-Onset), polyarticular-onset, and pauciarticular-onset. Adult-onset cases of Still's disease (STILL'S DISEASE, ADULT-ONSET) are also known. Only one subtype of juvenile rheumatoid arthritis (polyarticular-onset, rheumatoid factor-positive) clinically resembles adult rheumatoid arthritis and is considered its childhood equivalent.

Surgical techniques used to correct or augment healing of chondral defects in the joints (CARTILAGE, ARTICULAR). These include abrasion, drilling, and microfracture of the subchondral bone to enhance chondral resurfacing via autografts, allografts, or cell transplantation.

Search BioPortfolio: