Treatment of Deep Osteochondritis Dissecans Lesions, Avascular Necrosis, and Osteochondral Defects of the Knee Using Autologous Bone Grafting

Author(s):  
Tom Minas
2021 ◽  
pp. 108-110
Author(s):  
Vimal kumar bairwa ◽  
Pradeep Singh ◽  
Rakesh verma ◽  
Shivbhagwan sharma ◽  
Arvind kumar bohra

BACKGROUND: Avascular necrosis (AVN) of the femoral head is a disease that usually affects patients in the 20-50 year age group of life. The disease progresses with time and if left untreated, it may leads to complete deterioration of the hip joint. Various treatments modalities are available as non-surgical, core decompression alone or with autologous bone graft or PRP or bone marrow aspirate or vascularised bular graft, osteotomies and hip replacement. We planned to evaluate the efcacy of core decompression and autologous bone grafting in the management of AVN of the hip. MATERIALS AND METHODS- We performed a prospective study with 20 patients of 20-50 years age group having cat-arlet stage 1 [8 patients ] and 2a [12 patients]. The study period was from January 2018 to December 2019. All patients were treated with core decompression and autologous cancellous bone grafting. Pre-operative Harris hip score [HHS], plain radiograph and MRI were compared with postoperative ones at different time intervals. RESULTS- Average Follow Up Period Was 12 Months And Average Age Group Of Presentation Was 31.1 Years . Males Were More Affected And Most Common Causes Were Idiopathic And Steroid Use. Average Preoperative Hhs Was 56.20 And Postoperative Hhs Was 80.15. At The End Of 1 Year, 12 Patients Showed Remission, 6 Patients Showed Preoperative Stage While 2 Patients Progressed To Advanced Stage And Required Arthroplasty. CONCLUSION-core Decompression And Autologous Bone Grafting Is Effective Treatment Modality In Early Avascular Necrosis Of Femur Head In Terms Of Radiological And Clinical Results And Delaying Arthroplasty


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Daniel Körner ◽  
Christoph E. Gonser ◽  
Stefan Döbele ◽  
Christian Konrads ◽  
Fabian Springer ◽  
...  

Abstract Background The aim of this study is to analyse the re-operation rate after surgical treatment of osteochondral lesions of the talus (OCLTs) in children and adolescents. Methods Between 2009 and 2019, 27 consecutive patients with a solitary OCLT (10 male, 17 female; mean age 16.9 ± 2.2 years; 8 idiopathic vs. 19 traumatic) received primary operative treatment (arthroscopy + bone marrow stimulation [BMS], n = 8; arthroscopy + retrograde drilling, n = 8; autologous chondrocyte implantation [ACI]/autologous bone grafting, n = 9; arthroscopy + BMS + retrograde drilling; n = 1; flake fixation, n = 1). Seventeen OCLTs were located at the medial and ten at the lateral talus. ‘Re-operation’ as the outcome measure was evaluated after a median follow-up of 42 months (range 6–117 months). Patients were further subdivided into groups A (re-operation, n = 7) and B (no re-operation, n = 20). Groups A and B were compared with respect to epidemiological, lesion- and therapy-related variables. Results Seven of 27 patients needed a re-operation (re-operation rate 25.9% after a median interval of 31 months [range 13–61 months]). The following operative techniques were initially used in these seven patients: arthroscopy + BMS n = 2, arthroscopy + retrograde drilling n = 4, ACI + autologous bone grafting n = 1. A comparison of group A with group B revealed different OCLT characteristics between both groups. The intraoperative findings according to the International Cartilage Repair Society (ICRS) classification revealed significantly more advanced cartilage damage in group B than in group A (p = 0.001). Conclusions We detected a re-operation rate of 25.9% after primary surgical OCLT treatment. Patients with re-operation had significantly lower ICRS classification stages compared to patients without re-operation.


2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Kohei Yamaura ◽  
Yutaka Mifune ◽  
Atsuyuki Inui ◽  
Hanako Nishimoto ◽  
Yasuhiro Ueda ◽  
...  

Olecranon apophyseal nonunion is an elbow injury from overuse that affects adolescent athletes such as baseball pitchers who participate in overhead throwing sports. However, such injury is rare in collision sports. Here, we report two patients with this condition who are Judo athletes. The purpose of this report was to describe three elbows with olecranon apophyseal nonunion in two adolescent patients participating in Judo. This is a case series; the level of evidence is 4. Two 15-year-old patients were evaluated. One suffered from unilateral and the other from bilateral chronic posterior elbow pain. They were diagnosed with olecranon apophyseal nonunion, which was treated using internal fixation and bone grafting. Radiographic evidence of the apophyseal union was observed four months postsurgery. Two elbows were treated with tension band wiring, then they underwent hardware removal six months postsurgery. Both patients returned to their previous levels of activities six months postsurgery. Internal fixation using autologous bone grafting was a useful treatment for these Judo athletes with olecranon apophyseal nonunion.


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