Open AccessSurgical treatment of stable foci of the osteochondritis dissecans in children: a systematic review
Author(s) -
Andrey Semenov,
Д. М. Кукуева,
Ю. Г. Липкин,
И. Н. Исаев,
Vladimir V. Koroteev,
Nikolaj Tarasov,
Ю. И. Лозовая,
Д. Ю. Выборнов
Publication year - 2021
Publication title -
detskaâ hirurgiâ
Language(s) - English
Resource type - Journals
eISSN - 2412-0677
pISSN - 1560-9510
DOI - 10.18821/1560-9510-2021-25-3-179-185
Subject(s) - osteochondritis dissecans , medicine , articular cartilage , femoral condyle , cartilage , data extraction , surgery , statistical evidence , systematic review , orthodontics , dentistry , medline , osteoarthritis , pathology , anatomy , alternative medicine , political science , law , statistics , null hypothesis , mathematics
. The osteochondritis dissecans (OCD) is a pathologic condition of osteochondral tissue predominantly in the femoral condyles, which is met most often in adolescents and which can lead to the formation of early arthrosis in the knee joint in the remote time. By modern concepts, stable OCD foci are the foci with intact articular cartilage without the risk of migration into the joint cavity. To date, there are very few studies in the world literature on the treatment of early stages of osteochondrosis dissecans. Material and methods. Two independent researchers have carried out a systematic review of literature sources (2000-2020 ) using Pubmed, Medline and GoogleScholar. 9 publications were selected for data analysis out of 5184 publications after the qualitative assessment by the Yang scale and the obtained consensus in disputable situations. Results. Statistical analysis of the obtained data with the Statistica program revealed that the average rate of OCD foci healing was seen in 86.7% (from 70.6 to 100%). The most effective outcomes were in the group of antegrade drilling (95.3% of healed foci), then in the group with biodegradable implants fixation (88.5%), then the group of antegrade drilling with the introduction of bone marrow aspirate concentrate (BMAC) - 76.9%, and then the retrograde drilling - 76.8%. Conclusion. The analysis performed have shown a significant heterogeneity in data reporting, different methods for diagnosing osteochondritis dissecans, different approaches to healing assessment as well as a small number of children in samples what determined the lack of statistical significance between different options of surgical treatment (p = 0.27). Carefully planned trials with a proper design, standardized techniques for healing assessment and time of their application as well as the assessment of comparison groups and of all other necessary factors affecting lesion healing are needed.