RESEARCH ARTICLE


Knee Osteochondritis Dissecans Treated by the AO Hook Fixation System: A Four Year Follow-Up of an Alternative Technique



Ioannis P Pengas*, 1, 3, Angelos Assiotis 2, Michail Kokkinakis 4, Wasim S Khan 1, Paul Meyers 3, James Arbuthnot 5, Michael J Mcnicholas 6
1 Joint Reconstruction Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP, UK
2 Department of Orthopaedics and Trauma Surgery, Central Middlesex Hospital, Acton Lane, London, NW10 7NS, UK
3 Department of Orthopaedics and Trauma Surgery, Warrington Hospital, Lovely Lane, Cheshire, WA5 1QG, UK
4 Department of Orthopaedics and Trauma Surgery, Evelina Childrens Hospital, Guy’s & St Thomas Hospital NHS Trust, Westminster Bridge Road, London, SE1 7EH, UK
5 Department of Orthopaedics and Trauma Surgery, Heart of England NHS Foundation Trust, Bordesley Green East, Birmingham, B9 5SS, UK
6 Department of Orthopaedics and Trauma Surgery, Aintree University Hospital, Liverpool, Merseyside L9 7AL, UK


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© Pengas et al.; Licensee Bentham Open.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/) which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to this author at the Joint Reconstruction Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP, UK; Tel: 07545083161; E-mail: yiannispengas@yahoo.com


Abstract

Surgical fixation is recommended for stable osteochondritis dissecans (OCD) lesions that have failed nonoperative management and for all unstable lesions. In this study we set out to describe and evaluate an alternative method of surgical fixation for such lesions. Five knees with unstable OCD lesions in four male adolescent patients with open physes were treated with the AO Hook Fixation System. The outcome was evaluated both clinically and with three separate outcome systems (IKDC 2000, KOOS, Lysholm) at one and a mean four year follow-up. We demonstrated excellent clinical results in all patients. At four years, all scoring systems demonstrated statistically significant improvement when compared to the preoperative status. Our study suggests that the AO Hook Fixation System is an alternative method of surgical intervention with comparable medium term results with other existing modes of fixation and the added biomechanical advantage of the absence of distracting forces during hardware removal.

Keywords: AO hook fixation system, knee, osteochondritis dissecans..