관절경하에 Herbert Screw 를 이용한 슬관절 박리성 골연골염의 치료

Between 1983 and 1991, we treated 10 knees of 8 patients with osteochondritis dissecans of the knee with arthroscopic Herbert screw fixation. The patients average age at the time of surgery was 20 and the average follow-up was 2 years and 3 months. The location of lesions were medial condyle in 7 knees, lateral condyle in 2 knees, and patella in I, The types of lesion were intact articular cartilage in 2 knees, detached articular cartilage in 7 knees, and 1oose fragment in 1. A second-look arthroseopy was performed on 4 knees to remove the Herbert screw. 3 of the 4 kaees had a sobd osteochondral fragment to probing after screw removal, and 1 demonstrated minimal fragment motion to probing after screw removal, 1 knee showed depression of fragment. Juxtaarticular tibial surface was not eroded in all 8 patients. Roentgenograms demonstrated 6 of the 10 lesions had complete union, 2 lesions, articular incongruity, 1 lesion, radiolucent line, and 1 lesion, mild degenerative changes. The average healing time was 10.2 weeks (8 - 16 weeks). According to the criteria of the Hughston rating scale for Osteochondritis Dissecans, there were 3 excellent, 5 good, 2 fair, no poor, and no failure. The results suggest that arthroscopic Herbert screw fixation is a useful and effective procedure for osteochondritis dissecans of the knee.