OSTEOCHONDRITIS-DISSECANS OF THE FEMORAL CONDYLES - LONG-TERM RESULTSOF EXCISION OF THE FRAGMENT

Nineteen patients with 20 osteochondritis dissecans lesions were evalu ated between 2 and 20 years after excision of a partially detached (gr ade III) or loose (grade IV) fragment from the femoral condyles. Evalu ation with the Hughston rating scale for osteochondritis dissecans rev ealed one excellent result, four good, four fair, six poor, and five f ailure results, Eleven patients had developed osteochondritis dissecan s before skeletal maturity, In contrast to what has been stated in the literature, the results in these patients were no better than in thos e who developed osteochondritis dissecans as adults. The short-term re sults of excision are good, but the long-term results are extremely po or. Consequently, we recommend bone grafting and replacement of the fr agment when it is technically possible because the long-term results a re better than those after excision.