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J Knee Surg 2014; 27(02): 147-156
DOI: 10.1055/s-0033-1360653
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Indications for Surgical Management of Osteochondritis Dissecans of the Knee in the Pediatric Population: A Systematic Review

Lauren Salci
1   Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
,
Olufemi Ayeni
2   Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
,
Marcel Abouassaly
2   Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
,
Forough Farrokhyar
3   Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
,
Joanne Abigail D'Souza
3   Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
,
Mohit Bhandari
2   Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
,
Devin Peterson
2   Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
› Author Affiliations
Further Information

Publication History

10 April 2013

06 September 2013

Publication Date:
14 November 2013 (online)

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Abstract

Several case series have been published exploring the surgical management of osteochondritis dissecans (OCD) of the knee in pediatric patients. This systemic review was performed to identify the surgical indications for this condition. A search of the Embase and Ovid Medline databases was performed to identify clinical studies reporting outcomes of surgical management of OCD in the knee in this patient population. A quality assessment of the included articles was conducted independently by two reviewers using a quality assessment tool developed by Yang et al. A total of 25 articles met the eligibility criteria and were reviewed; 40% of studies did not clearly describe their surgical indications. The remainder of the studies had a failure of nonoperative management with or without the concomitant use of imaging as their indication for surgery, or used lesion stability itself as the indication for surgery. This review outlines several surgical indications presented in the literature for the treatment of OCD lesions of the knee in the pediatric population. The most common indication for surgery was a failure of a trial of nonoperative treatment with or without the concomitant use of serial imaging. Although the quality of the case series was high, inconsistencies in reporting radiographic and arthroscopic classification of the OCD lesion were common.

Keywords

osteochondritis dissecans - knee - pediatric - systematic review
 

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