The purpose of this study is to compare the functional, clinical and radiographic outcomes associated with trans-articular drilling versus retro-articular drilling, two commonly employed techniques of operative treatment for stable forms of juvenile osteochondritis dissecans (JOCD) lesions. This study also aims to better define the natural history of this condition in its most commonly identified pathological state (as a stable lesion) following surgical intervention by determining the rate of radiographic healing and any need for secondary surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
91
* Drilling must be performed under AP and lateral fluoroscopic guidance, with no additional drilling in 'trans-articular', or intra-articular trans-condylar fashion. * Use a 0.045 K-wire for drilling. * Minimum of 8 wire passes per square centimeter with no maximum number of wire passes.
* Drilling must be performed, under arthroscopic visualization, directly through the articular cartilage, with no additional drilling in 'retro-articular', 'extra-articular', or trans-condylar (through the intercondylar notch) * Use a 0.045 K-wire for drilling * A minimum 4 wire passes per square centimeter, with a maximum of 5 wire passes per square centimeter
Kaiser Permanente Los Angeles
Los Angeles, California, United States
Rady Children's Hospital
San Diego, California, United States
Rocky Mountain Hospital for Children
Centennial, Colorado, United States
Connecticut Children's Medical Center
Farmington, Connecticut, United States
St. Luke's Children's Hospital
Boise, Idaho, United States
Boston Children's Hospital
Boston, Massachusetts, United States
Washington University School of Medicine
St Louis, Missouri, United States
Hospital for Special Surgery
New York, New York, United States
Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio, United States
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
...and 4 more locations
Physical functioning measured by the Pedi-IKDC (International Knee Documentation Committee) total score
Time frame: One year post-surgery
Activity level as measured by the Marx Activity Scale
Time frame: One year post-surgery
Physical functioning as measured by the Pedi-IKDC total score
Time frame: Two years post-surgery
Time to lesion healing
Lesion healing will be assessed by x-ray at multiple time points
Time frame: 3 months to 2 years post-surgery
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.