LONG-TERM RESULTS AFTER REFIXATION OF OSTEOCHONDRAL FRAGMENTS IN CASES OF OSTEOCHONDRITIS-DISSECANS AT THE TALAR DOME AND FEMORAL CONDYLES - THE USE OF CYANOACRYLATE AND FIBRIN GLUE

Long-term results after surgical treatment of osteochondritis dissecan s of the talar dome and joint knee are dependent on the stage of carti lage damage, the age at operation and on the surgical technique. In ca ses of osteochondritis dissecans of the talar dome the only loosening of a refixed osteochondral fragment was seen after glueing with acryla te. Using the classification of Arcq in 59.6% an excellent and in 18.3 % a good result was observed in cases of osteochondritis dissecans at the femoral condyles. In regard to the development of osteoarthritis i n 56% no signs of osteoarthritis were visible. Worst results were obta ined in knee joints in which acrylate glue was used for refixation of the osteochondral fragments. In conclusion we recommend the use of fib rin glue for refixation of osteochondral fragments in cases of osteoch ondritis dissecans even when early mobilisation follows the operation. Because of the long-lasting resorption and barrier effect to ingrowin g tissue the use of cyanoacrylate should be avoided.