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01-06-2011 | Technical Report

MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the knee

Authors: Risto Ojala, Pekka Kerimaa, Martti Lakovaara, Pekka Hyvönen, Petri Lehenkari, Osmo Tervonen, Roberto Blanco-Sequeiros

Published in: Skeletal Radiology | Issue 6/2011

Abstract

Objective

The purpose of this study was to evaluate the feasibility of a new method for osteochondritis dissecans (OCD) treatment.

Materials and methods

Ten OCD lesions of the knee unresponsive to conservative management were treated with MRI-guided percutaneous retrograde drilling to reduce symptoms and promote ossification of the lesion. All lesions were located in distal femoral condyles. Only stable OCD lesions were included (preprocedural MRI grade I or II). Five lesions were of juvenile type and five lesions were of adult type OCD. All the patients had severe limitation of activity due to the OCD-related pain.

By using a 0.23 T open MRI scanner and spinal anesthesia, percutaneous retrograde drilling of the OCD lesions was performed (3 mm cylindrical drill, one to three channels). Optical tracking and MRI imaging were used to guide instruments during the procedure. Mean postprocedural clinical follow-up time was 3 years. Eight patients had a post-procedural follow-up MRI within 1 year.

Results

All the OCD lesions were located and drilled using the 0.23 T open MRI scanner without procedural complications. All the patients had pain relief, mean visual analog score (VAS) declined from 6 to 2. Follow-up MRI showed ossification in all lesions. Eight patients could return to normal physical activity with no or minor effect on function (Hughston score 3–4). Treatment failed in two cases where the continuation of symptoms led to arthroscopy and transchondral fixation.

Conlusion

MR-guided retrograde OCD lesion drilling is an accurate, feasible, and effective cartilage-sparing techique in OCD management.

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Title: MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the knee
Authors: Risto Ojala
Pekka Kerimaa
Martti Lakovaara
Pekka Hyvönen
Petri Lehenkari
Osmo Tervonen
Roberto Blanco-Sequeiros
Publication date: 01-06-2011
Publisher: Springer-Verlag
Published in: Skeletal Radiology / Issue 6/2011
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI: https://doi.org/10.1007/s00256-011-1118-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the knee

Abstract

Objective

Materials and methods

Results

Conlusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Materials and methods

Results

Conlusion

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