gms | German Medical Science

Although osteochondrosis dissecans (o.c.d.) of the femoral condyles is the most often occurring location little is known about long-term results. It was the aim of our study to re-analyse patients suffering from o.c.d. of the femoral condyle which had been operated on several years ago.

42 patients suffering from different stages of o.c.d. of the femoral condyles which were operated using different surgical techniques depending on the stage of o.c.d. were followed-up clinically (Lysholm-Score) and radiologically (Tapper-score, Wirth-score for OA) at a mean interval of 10 & 20 years.

At the first follow-up we found a mean Lysholm-Score of 83.2 (21-100, SD 19.6) pts.. The value increased to 91.2 pts at the 2. follow-up. Patients with juvenile OCD exhibited significant better results than adults (p= 0.024). Regarding osteoarthritic changes in 56.3% no changes, in 21.9 % 1°-changes, in 3.1% 3°- changes, in 6.3 % 3°- changes & in 12.5 % 4° changes. The mean stage postop. was 0.74. Ten years later similar results were found: in 56.3% no osteoarthritic changes were seen. 1°-changes were found in 21.9%, 2°- changes in 3.1% and 3°-changes in 6.3% and severe osteoarthritic 4°-cchanges were found in 12.5%. In comparison to the first follow-up at the date of the 2nd follow-up no individual changes could be detected in 73 %, a slight impairment in 11.5 % & a slight improvement in 15.4%.

Best clinical and long-term results with a low incidence of osteoarthritis are to obtain in cases with o.c.d. with intact cartilage layer not necessitating cartilage damage.