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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 6, 823-829.
doi: 10.1302/0301-620X.91B6.20957  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Histological evaluation of internally-fixed osteochondral lesions of the knee

N. Adachi, MD, Assistant Professor1; M. Motoyama, MD, Orthopaedic Surgeon1; M. Deie, MD, Assistant Professor1; M. Ishikawa, MD, Orthopaedic Surgeon1; K. Arihiro, MD, Pathologist, Associate Professor2; and M. Ochi, MD, Professor and Chairman1

1 Department of Orthopaedic Surgery
2 Department of Anatomical Pathology Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.

Correspondence should be sent to Professor M. Ochi; e-mail: ochim{at}hiroshima-u.ac.jp

We evaluated the histological changes before and after fixation in ten knees of ten patients with osteochondritis dissecans who had undergone fixation of the unstable lesions. There were seven males and three females with a mean age of 15 years (11 to 22). The procedure was performed either using bio-absorbable pins only or in combination with an autologous osteochondral plug. A needle biopsy was done at the time of fixation and at the time of a second-look arthroscopy at a mean of 7.8 months (6 to 9) after surgery.

The biopsy specimens at the second-look arthroscopy showed significant improvement in the histological grading score compared with the pre-fixation scores (p < 0.01). In the specimens at the second-look arthroscopy, the extracellular matrix was stained more densely than at the time of fixation, especially in the middle to deep layers of the articular cartilage.

Our findings show that articular cartilage regenerates after fixation of an unstable lesion in osteochondritis dissecans.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General