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Open Access 01-12-2021 | Magnetic Resonance Imaging | Research article

Electromagnetic navigation reduces radiation exposure for retrograde drilling in osteochondrosis dissecans of the talus

Authors: Oliver D Jungesblut, Josephine Berger-Groch, Michael Hoffmann, Malte Schroeder, Kara L. Krajewski, Ralf Stuecker, Martin Rupprecht

Published in: BMC Musculoskeletal Disorders | Issue 1/2021

Abstract

Background

Retrograde drilling in osteochondrosis dissecans (OCD) is a widely used surgical intervention. A radiation-free electromagnetic navigation system (ENS)-based method was compared with the standard freehand fluoroscopic (SFF) method regarding clinical applicability.

Methods

We performed a clinical cohort study at a department of Orthopaedics in a Level 1 children’s hospital with 40 patients (20 SFF and 20 ENS). Retrograde drilling of the talar dome was used in patients with unstable medial OCD (MRI stage 2 according to Hepple’s revised classification; stage 2 according to the International Cartilage Repair Society). The outcome measurements were: (a) Intraoperative fluoroscopy exposure and length of surgery and (b) Postoperative serial follow-up MRIs every 6 months.

Results

22 female and 18 male patients aged 13.8 ± 1.6 years (range: 11–17 years) were included. Using the ENS technique, length of surgery was significantly reduced to 20.2 ± 6.4 min compared to 36.1 ± 11.8 min (p < 0.01) for the SFF technique. The average x-ray radiation time for the SFF technique was 23.5 ± 13.5 sec and 1.9 ± 1.7 sec for the ENS technique (p < 0.01). Radiation exposure was significantly reduced from 44.6 ± 19.7 mSv (SFF technique) to 5.6 ± 2.8 mSv (ENS technique) (p < 0.01). Intraoperative perforation of cartilage occurred once in the SFF group. Correct placement of the drilling channel was verified in all patients on follow-up MRI after six months and a timely healing was seen after two years.

Conclusions

The ENS method provides for a significant reduction in length of surgery and radiation exposure. ENS was without intraoperative cartilage perforation. The clinical and radiological follow-up parameters are comparable for SFF- and ENS-guided retrograde drilling.

Trial registration

WF – 085/20, 05/2020 “retrospectively registered” https://www.aerztekammer-hamburg.org/ethik_kommission.html.

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Title: Electromagnetic navigation reduces radiation exposure for retrograde drilling in osteochondrosis dissecans of the talus
Authors: Oliver D Jungesblut
Josephine Berger-Groch
Michael Hoffmann
Malte Schroeder
Kara L. Krajewski
Ralf Stuecker
Martin Rupprecht
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Osteochondrosis Dissecans
Published in: BMC Musculoskeletal Disorders / Issue 1/2021
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-021-04010-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Electromagnetic navigation reduces radiation exposure for retrograde drilling in osteochondrosis dissecans of the talus

Abstract

Background

Methods

Results

Conclusions

Trial registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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