Juvenile osteochondritis of femoral condyles: treatment with transchondral drilling. Analysis of 40 cases.

Abstract

Osteochondritis dissecans (OCD) of the femoral condyle is a rare lesion. A retrospective study (level IV evidence) analyzing a series of 40 pediatric cases with juvenile femoral condyles osteochondritis treated by arthroscopic multiple transchondral drilling between February 1999 and June 2008 was undertaken. This lesion affected the medial condyle in 87.5% of cases. The average age at treatment was 13.4 years. Our study took into account the location of the lesion and its radiological evolutionary stage. The average follow up was 14.8 months. The postoperative evaluation was based on the clinical and radiological scores of Hughston. Good clinical and radiological results in 97.5 and 95% of cases, respectively were obtained, with a significant correlation (P < 0.001) between clinical scores and radiological Hughston scores. The closed nature of the growth plate during surgery has a significant deleterious effect (P < 0.001) on the clinical and radiological score of Hughston. All patients presenting juvenile condylar osteochondritis with open growth plate during treatment had good clinical and radiological results, confirming the validity and effectiveness of multiple transchondral drilling in this type of lesion.