Prognostic factors of adult osteochondritis dissecans in the knee

ABSTRACT

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.