{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T23:01:20Z","timestamp":1789081280269,"version":"build-2803163510"},"reference-count":29,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2019,11,10]],"date-time":"2019-11-10T00:00:00Z","timestamp":1573344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The aim of the present study is to describe results at long-term follow-up of internal fixation of unstable Osteochondritis Dissecans (OCD) achieved with three different fixation devices in skeletally mature knees. A retrospective cohort study was performed at 5 to 19 years follow-up. Patient-reported questionnaires were collected at the final follow-up. Postoperative X-rays and MRIs were evaluated for healing of the lesion and articular degeneration. An arthroscopic second look was performed in 74.3% of the cases. Failures were reported as reintervention to address the osteochondral lesion or poor functional outcomes at the last follow-up. A total of 39 subjects with a median follow-up of 10.7 years were included. Herbert screws were used in 51.2% of the cases, bioabsorbable nails in 25.7% of the cases and cannulated screws in 23.1% of the cases. No differences were observed in terms of the clinical score (International Knee Documentation Committee (IKDC) p = 0.211; Lysholm p = 0.197), radiographic union (p = 0.102) or radiographic degeneration (p = 0.238) between the three different fixation devices. Arthroscopic second look found complete stability of the lesions in all 29 cases evaluated. The mean postoperative Lysholm score was 83 (range = 33\u2013100) and IKDC score was 79 (range = 39\u2013100). Radiographic union was seen in 74% of the cases. Lack of radiographic union was correlated with worst functional scores. A failure rate of 20.5% was found: four reinterventions were performed, and four patients had poor scores at last follow up. This study shows that internal fixation of condylar OCD in skeletally mature patients provides good long-term clinical results and a high degree of healing regardless of the dimensions of the lesion and type of fixation.<\/jats:p>","DOI":"10.3390\/jcm8111934","type":"journal-article","created":{"date-parts":[[2019,11,12]],"date-time":"2019-11-12T04:07:07Z","timestamp":1573531627000},"page":"1934","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Internal Fixation of Osteochondritis Dissecans of the Knee Leads to Good Long-Term Outcomes and High Degree of Healing without Differences between Fixation Devices"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0010-024X","authenticated-orcid":false,"given":"Simone","family":"Perelli","sequence":"first","affiliation":[{"name":"Institut Catal\u00e0 de Traumatologia i Medicina de l\u2019Esport (ICATME)\u2014Hospital Universitari Dexeus, Universitat Aut\u00f2noma de Barcelona, 08028 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0970-7737","authenticated-orcid":false,"given":"Agust\u00edn Rub\u00e9n","family":"Molina Romoli","sequence":"additional","affiliation":[{"name":"Research Department, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires c1181ach, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mat\u00edas","family":"Costa-Paz","sequence":"additional","affiliation":[{"name":"Department of Knee Arthroscopy, Hospital Italiano de Buenos Aires, Buenos Aires c1181ach, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Ignacio","family":"Erquicia","sequence":"additional","affiliation":[{"name":"Institut Catal\u00e0 de Traumatologia i Medicina de l\u2019Esport (ICATME)\u2014Hospital Universitari Dexeus, Universitat Aut\u00f2noma de Barcelona, 08028 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo Eduardo","family":"Gelber","sequence":"additional","affiliation":[{"name":"Institut Catal\u00e0 de Traumatologia i Medicina de l\u2019Esport (ICATME)\u2014Hospital Universitari Dexeus, Universitat Aut\u00f2noma de Barcelona, 08028 Barcelona, Spain"},{"name":"Department of Orthopaedic Surgery, Hospital de la Sta Creu i Sant Pau, Universitat Aut\u00f2noma de Barcelona, 08028 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2418-4874","authenticated-orcid":false,"given":"Juan Carlos","family":"Monllau","sequence":"additional","affiliation":[{"name":"Institut Catal\u00e0 de Traumatologia i Medicina de l\u2019Esport (ICATME)\u2014Hospital Universitari Dexeus, Universitat Aut\u00f2noma de Barcelona, 08028 Barcelona, Spain"},{"name":"Department of Orthopaedic Surgery, Hospital del Mar, Universitat Aut\u00f2noma de Barcelona, 08028 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,11,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.1016\/j.joca.2017.07.005","article-title":"Incidence of symptomatic osteochondritis dissecans lesions of the knee: A population-based study in Olmsted County","volume":"25","author":"Pareek","year":"2017","journal-title":"Osteoarthr. Cartil."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Andriolo, L., Crawford, D.C., Reale, D., Zaffagnini, S., Candrian, C., Cavicchioli, A., and Filardo, G. (2018). Osteochondritis Dissecans of the Knee: Etiology and Pathogenetic Mechanisms. A Systematic Review. Cartilage.","DOI":"10.1177\/1947603518786557"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Bruns, J., Werner, M., and Habermann, C. (2017). Osteochondritis Dissecans: Etiology, Pathology, and Imaging with a Special Focus on the Knee Joint. Cartilage.","DOI":"10.1177\/1947603517715736"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1097\/MOP.0b013e32835adbf5","article-title":"Osteochondritis dissecans of the knee in children and adolescents","volume":"25","author":"Moran","year":"2013","journal-title":"Curr. Opin. Pediatr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1177\/0363546506290127","article-title":"Management of osteochondritis dissecans of the knee: Current concepts review","volume":"34","author":"Kocher","year":"2006","journal-title":"Am. J. Sports Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2512","DOI":"10.1016\/j.arthro.2019.03.020","article-title":"Does Internal Fixation for Unstable Osteochondritis Dissecans of the Skeletally Mature Knee Work? A Systematic Review","volume":"35","author":"Leland","year":"2019","journal-title":"Arthrosc. J. Arthrosc. Relat. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1177\/03635465010290051301","article-title":"Development and Validation of the International Knee Documentation Committee Subjective Knee Form","volume":"29","author":"Irrgang","year":"2001","journal-title":"Am. J. Sports Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1177\/0363546508330143","article-title":"The Reliability, Validity, and Responsiveness of the Lysholm Score and Tegner Activity Scale for Anterior Cruciate Ligament Injuries of the Knee","volume":"37","author":"Briggs","year":"2009","journal-title":"Am. J. Sports Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"58","DOI":"10.2106\/00004623-200300002-00008","article-title":"Evaluation of cartilage injuries and repair","volume":"85","author":"Brittberg","year":"2003","journal-title":"J. Bone Jt. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1467","DOI":"10.1177\/0363546507300692","article-title":"Comparison of bioabsorbable pins and nails in the fixation of adult osteochondritis dissecans fragments of the knee: An outcome of 30 knees","volume":"35","author":"Parviainen","year":"2007","journal-title":"Am. J. Sports Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2212","DOI":"10.1177\/0363546511416594","article-title":"Functional and radiographic outcomes of juvenile osteochondritis dissecans of the knee treated with extra-articular retrograde drilling","volume":"39","author":"Boughanem","year":"2011","journal-title":"Am. J. Sports Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1136\/ard.16.4.494","article-title":"Radiological Assessment of Osteo-Arthrosis","volume":"16","author":"Kellgren","year":"1957","journal-title":"Ann. Rheum. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1177\/0363546517699846","article-title":"High rate of osteoarthritis after osteochondritis dissecans fragment excision compared with surgical restoration at a mean 16-Year Follow-up","volume":"45","author":"Sanders","year":"2017","journal-title":"Am. J. Sports Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1097\/01.blo.0000128216.10732.d8","article-title":"Osteochondritis dissecans of the knee: Long-term results of excision of the fragment","volume":"424","author":"Wright","year":"2004","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0246-0521(06)40346-6","article-title":"Ost\u00e9ochondrite diss\u00e9quante des condyles f\u00e9moraux","volume":"1","author":"Moyen","year":"2006","journal-title":"Appar. Locomoteur"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.otsr.2017.10.005","article-title":"Hybrid fixation in adult osteochondritis dissecans of the knee","volume":"104","author":"Chadli","year":"2018","journal-title":"Orthop. Traumatol. Surg. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.injury.2008.01.041","article-title":"Autologous osteochondral grafting-Technique and long-term results","volume":"39","author":"Hangody","year":"2008","journal-title":"Injury"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.knee.2014.10.001","article-title":"Arthroscopic mosaicplasty: Long-term outcome and joint degeneration progression","volume":"22","author":"Filardo","year":"2015","journal-title":"Knee"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1726","DOI":"10.1007\/s00167-018-5316-5","article-title":"Treatment of unstable knee osteochondritis dissecans in the young adult: Results and limitations of surgical strategies\u2014The advantages of allografts to address an osteochondral challenge","volume":"27","author":"Filardo","year":"2019","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1177\/0363546510392711","article-title":"Novel nano-composite multilayered biomaterial for osteochondral regeneration: A pilot clinical trial","volume":"39","author":"Kon","year":"2011","journal-title":"Am. J. Sports Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1302\/0301-620X.97B3.34555","article-title":"Treatment of osteochondral lesions in the knee using a cell-free scaffold","volume":"97","author":"Verdonk","year":"2015","journal-title":"Bone Jt. J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1007\/s00167-013-2778-3","article-title":"Ten-year clinical and radiographic outcomes after autologous chondrocyte implantation of femoral condyles","volume":"22","year":"2014","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1177\/1947603515622662","article-title":"Internal Fixation of Unstable Osteochondritis Dissecans in the Skeletally Mature Knee with Metal Screws","volume":"7","author":"Barrett","year":"2016","journal-title":"Cartilage"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2065","DOI":"10.1177\/0363546510371369","article-title":"Bioabsorbable fixation of unstable osteochondritis dissecans lesions","volume":"38","author":"Millington","year":"2010","journal-title":"Am. J. Sports Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1016\/j.arthro.2009.10.009","article-title":"Fixation of Detached Osteochondritis Dissecans Lesions With Bioabsorbable Pins: Clinical and Histologic Evaluation","volume":"26","author":"Yonetani","year":"2010","journal-title":"Arthrosc. J. Arthrosc. Relat. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1177\/0363546508328119","article-title":"Does operative fixation of an osteochondritis dissecans loose body result in healing and long-term maintenance of knee function?","volume":"37","author":"Magnussen","year":"2009","journal-title":"Am. J. Sports Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1177\/0363546506296608","article-title":"Internal fixation of juvenile osteochondritis dissecans lesions of the knee","volume":"35","author":"Kocher","year":"2007","journal-title":"Am. J. Sports Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2394","DOI":"10.1177\/0363546518783737","article-title":"Internal Fixation of Unstable Osteochondritis Dissecans: Do Open Growth Plates Improve Healing Rate?","volume":"46","author":"Wu","year":"2018","journal-title":"Am. J. Sports Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1177\/0363546505274717","article-title":"Arthroscopic fixation of osteochondritis dissecans of the knee: Clinical, magnetic resonance imaging, and arthroscopic follow-up","volume":"33","author":"Makino","year":"2005","journal-title":"Am. J. Sports Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/11\/1934\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:33:20Z","timestamp":1760189600000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/11\/1934"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,10]]},"references-count":29,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2019,11]]}},"alternative-id":["jcm8111934"],"URL":"https:\/\/doi.org\/10.3390\/jcm8111934","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,10]]}}}