Prognostic factors of adult osteochondritis dissecans in the knee

PURPOSE: To analyze factors related to prognoses of adult osteochondritis dissecans. MATERIALS AND METHODS: 19 cases of osteochondritis dissecans(16 patients) were studied for 9 years(19901998) and mean follow-up was 3 years 5 months(2 years-5 years 6 months). To evaluate factors possibly related to prognoses, age at the onset of symptom and location, size, and degrees of progres-sion of the lesion were compared with final results. RESULTS: Clinical symptoms were improved in all cases, and evaluation with the Huston rating scale for osteochondritis dissecans revealed 2 excellent result, 9 good, 6 fair, 1 poor, and 1 failure. The results for the patients who initially developed symptoms before epiphyseal closure were better than for the patients who developed symptoms after epiphyseal closure, Lesions of non-weight-bearing area showed better results than lesions of weight bearing area. There were no relations between final results and lesions size. The lower stage of pathologic deterioration of the lesion had the better results. CONCLUSION: After arthroscopic treatment for osteochondritis dissecans, clinical results were improved in all cases, but radiologic results showed various results from complete healing to joint space narrowing. Radiologic finding determined final results. Age at the onset of symptoms and location and degrees of progression of the lesion have direct relationship with final results, but because this study for prognosis factor is short term result, long term follow up will be needed.

A Clinical Study of Tarsometatarsal Joint Injuries / 대한정형외과학회잡지

Authors reviewed and clinically analysed 34 cases of trasometatarsal joint injury treated at the Orthopedic department of Pusan National University Hospital during the period from January 1975 to December 1979, and following results were obtained. 1. The incidence was higher in male and the active age group of 20-40. 2. Among the causes, traffic accidents were 22 cases (64.7%) and crushing injuries in the industrial field were 6 cases (17.6%). 3. Fracure-dislocations were higher than simple dislocation. 4. According to the Wilsons Classifications, the injuries were classified as follows. First stage of supination (51), 11 cases (32.4%): First stage of pronation (P1), 8 cases (23.5%): Plantar-flexion alone (PF), 4 cases (11.8%): Second stage of supination (S2), 3 cases (8.8%): Second stage of pronation (P2), 2 casese (5.9%): And finally direct crushing injuries,were 6 cases (17.6%): 5. Associated injuries were fracture of the metatarsal bone in 15 cases (44.1%), fractures of the tarsal bone in 7 cases (20.6%) and severe soft tissue injuries in 6 cases (17.6%), 6. The operative treatments with early anatomical reduction were obtained better results than conservative treatment. 7. As complications, pain in 31 cases (91.2%), bony deformity in 26 cases (76.5%), motion limitation in 32 cases (94.1%), skin necrosis in 3 cases (8.8%) and traumatic arthritis in 23 cases (67.6%) were observed.