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. 2022 Apr;160(2):183-189.
doi: 10.1055/a-1289-0733. Epub 2020 Nov 24.

Bioabsorbable Unsintered Hydroxyapatite/Poly-l-Lactic Acid Pin Fixation of Osteochondritis Dissecans in Adolescents: Initial Experiences

Martin Georg Zeilinger  1 , Christian Autenrieth  2 , Kerstin Remmel  3 , Alexander Schuh  4 , Matthias Hammon  1 , Annemarie Schraml  3 , Michael Uder  1 , Oliver Rompel  1
Affiliations

Bioabsorbable Unsintered Hydroxyapatite/Poly-l-Lactic Acid Pin Fixation of Osteochondritis Dissecans in Adolescents: Initial Experiences

Martin Georg Zeilinger et al. Z Orthop Unfall. 2022 Apr.

Abstract
in English, German

Background: This study sought to retrospectively evaluate the clinical and magnetic resonance imaging (MRI) outcomes of u-HA/PLLA pin (u-HA/PLLA: hydroxyapatite/poly-L-lactic acid) pin fixation of unstable osteochondritis dissecans (OCD) lesions of the knee.

Methods: Seven adolescent patients (four females and three males) with arthroscopically unstable OCD lesions of the knee were included. The mean age at diagnosis was 13.1 years. Clinical results were evaluated preoperatively and during follow-up using the Ogilvie-Harris score (0 - 15 points). MRI scans were performed preoperatively and during follow-up, with results evaluated using the Dipaola classification (grades 1 - 4). Mean follow-up time was 29 months.

Results: The median Ogilvie-Harris score improved from 13 points (range: 10 - 14 points) to 15 points (range: 13 - 15 points). Separately, the median Dipaola score improved from 3 points (range: 2 - 4 points) to 1 point (range: 1 - 4 points). No complications such as infection, synovitis, or intra-articular adhesion were observed.

Conclusions: Initial experiences using bioabsorbable u-HA/PLLA pins for the refixation of unstable OCD lesions in adolescents in the knee are promising, and MRI provides excellent monitoring of healing.

Hintergrund: Retrospektive klinische und MRT-basierte (MRT: Magnetresonanztomografie) Auswertung einer ersten Fallserie von mittels bioabsorbierbaren u-HA/PLLA-Pins (u-HA/PLLA: ungesintertes Hydroxylapatit/Poly-L-Laktat) fixierten instabilen Osteochondrosis dissecans (OCD)-Läsionen des Kniegelenkes.

Methode: Eingeschlossen wurden sieben Jugendliche (vier weiblich, drei männlich) mit arthroskopisch instabilen OCD-Läsionen des Kniegelenkes. Das mittlere Alter bei Diagnose betrug 13,1 Jahre. Die Auswertung erfolgte präoperativ und im Follow-up über durchschnittlich 29 Monate, jeweils klinisch mit dem Ogilvie-Harris Score (0 – 15 Punkte) bzw. mittels MRT-Untersuchungen und dem Dipaola Score (Grad 1 – 4).

Resultate: Der mediane Ogilvie-Harris-Score verbesserte sich von 13 Punkten (Range: 10 – 14 Punkte) auf 15 Punkte (Range: 13 – 15 Punkte). Der mediane Dipaola Score verbesserte sich von 3 Punkten (Range: 2 – 4 Punkte) auf 1 Punkt (Range: 1 – 4 Punkte). Es wurden keine Komplikationen wie Infektionen, Synovitis oder intraartikuläre Adhäsionen festgestellt.

Zusammenfassung: Erste Erfahrungen mit bioabsorbierbaren u-HA/PLLA-Pins in der Refixierung von instabilen OCD-Läsionen im Knie sind vielversprechend. Das MRT erlaubt eine hervorragende Beurteilung des Heilungsverlaufes.

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Conflict of interest statement

Financial support was agreed by Däumer International for additional MRI scans and financial recompense for volunteering patients, but there was no influence from this on the study protocol or the study evaluation. The authors declare that no other conflicts of interest exist.

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