Therapie der Osteochondrosis dissecans des Kniegelenks |
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Authors: | Dr J Lützner J Mettelsiefen KP Günther F Thielemann |
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Institution: | 1. Orthop?dische Klinik, Universit?tsklinikum Carl Gustav Carus, Fetscherstra?e 74, 01307, Dresden, Deutschland
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Abstract: | Osteochondritis dissecans (OD) is a lesion of the subchondral bone which can result in sequestration of the osteochondral lesion. It is categorized into 4 stages, and juvenile and adult forms depending on the distal femoral physis maturity. Prognosis and treatment depends on age and stage. Prognosis is favorable in stable lesions (stage I and II) at typical location (medial femoral condyle) in a child with open physes. Therefore non-operative treatment is indicated. If there is no response to non-operative treatment drilling to create channels for potential revascularization can be done. In unstable lesions (stage III and IV) operative treatment is necessary. Long-term results after excision of the fragment with or without drilling of the defect site are poor. Therefore refixation of an intact osteochondral fragment or biologic reconstruction should be tried. |
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