The Journal of Bone and Joint Surgery, Vol 60, Issue 2 235-240, Copyright © 1978 by Journal of Bone and Joint Surgery, Inc
Osteochondritis dissecans of the knee with loose fragments. Treatment by replacement and fixation with readily removed pins
PR Lipscomb, PR Lipscomb and RS Bryan
We reviewed six patients with a five to fifteen-year follow-up and a
seventh with shorter follow-up who underwent replacement and fixation with
easily removable pins of large osteocartilaginous fragments resulting from
osteochondritis dissecans. Excellent or good results were achieved in all
but one patient. Preparation of the fragments to fit into their
vascularized beds prior to internal fixation is advisable, and in some
cases the bed should be partially filled with cancellous bone before the
fragments are replaced. Immobilization is prescribed until the pins are
removed three to six weeks after surgery. Weightbearing is delayed until
there is roentgenographic evidence of beginning union of the fragment to
the underlying bone.