Exclusion criteria included traumatic osteochondral fractures or coexistence of non-OCD intra-articular lesions. Some previous activities are limited due to the pain. I am also having a Brostrom procedure concurrently to reconstruct my outer ligament. 3 months ago I got injuries at work, and at first didn't think it was bad... Fast forward to now. It also does not elucidate any relationship between the types of surgeries performed and the intraoperative and radiographic findings. For more information view the SAGE Journals Article Sharing page. While my foot also gets quite warm if I stand or sit for too long, these more dramatic episodes occur only at night. At least I thought so at the time.Went through several months of PT and it seemed pretty good. A case report, Osteochondritis dissecans of the femoral condyles. Other than my doc having issues with the cartilage flaking off when he tried to clean things out - all went well. Just wondering if anyone has undergone the "atomizer" procedure to relieve their hemorrhoids? Re: Success rate for microfracture surgery for OCD of talus. Patients aged 12 to 19 years had a 7.4-times greater risk of progression to surgery for knee OCD lesions than 6- to 11-year-olds. Otherwise consultation with a physician specializing in treating OCD lesions (such … The majority of lesions (61.7%) were in the knee, with ankle, elbow, shoulder, and foot lesions representing 25.4%, 12.0%, 0.6%, and 0.3% of all lesions, respectively. I'm scared to try it! The literature is quite variable regarding progression to surgery for ankle OCD, with a surgical intervention rate between 19% and 58% in multiple studies. Osteochondritis dissecans (OCD or OD) is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone. I see him on Monday, which will be 12 days post-op, and he plans to put me in a boot with a small amt of weight bearing at that time. By overheating, I mean that the surgery foot turns bright red, and gets exceptionally warm... the big toe joint area gets downright hot to the touch (there is no infection present) and feels as though there is a space heater sitting about an inch in front of my foot. This study confirms the markedly increased likelihood of progression to surgery among older patients for OCD as a whole and knee OCD specifically and confirms the findings of many prior studies that in each type of OCD, chondroplasty or debridement is the most common procedure performed. But overall, the success rate has increased a lot in the case of ankle replacement surgery. Access to society journal content varies across our titles. Progression to surgery for OCD of the knee, elbow, and ankle strongly correlated with patient age at the time of diagnosis. This product could help you, Accessing resources off campus can be a challenge. Surgery was totally fine -- was unaware of everything. I was not given any form of cast or boot.Between discharge and my post op review I stayed mainly non weight bearing but after a week or so I started trying to partial weight bear and tried to walk without crutches. Inclusion criteria included OCD of any joint and patients aged 2 to 19 years. The percentage of all OCD lesions progressing to surgery was 35.3%; surgical progression for knee, ankle, and elbow joints was 33.5%, 31.8%, and 55.0%, respectively. Unfortunately, this approach in the ankle has not yet met with the type of clinical success that had been hoped for, and is not currently broadly available. Inclusion criteria included OCD of any joint and patients aged 2 to 19 years at the time of diagnosis. Exclusion criteria included traumatic osteochondral fractures, less than 1 year of follow-up, and the coexistence of any intra-articular lesions other than OCD. Surgical intervention for osteochondritis dissecans (OCD) has long been recognized as an important aspect of the treatment algorithm.17,38,40 While conservative (nonoperative) treatment is often utilized for early stage or stable lesions, lesions that fail to heal, appear unstable by magnetic resonance imaging (MRI), or coincide with the presence of loose bodies may require surgical intervention. So I have an appointment on Monday to actually SEE the MRI results and discuss/set-up surgery. I had three procedures two weeks ago - microfracture for talus, brostrom- gault repair and debridement. I'm 13 days post op from ankle microfracture and debridement of a small OCD lesion and so far it's been an emotional roller coaster being NWB and all. Recent advancements in Ankle Replacement surgery has increased the success rates and significantly improved the surgical procedure. Kocher, MS, Micheli, LJ, Yaniv, M, Zurakowski, D, Ames, A, Adrignolo, AA. My surgery is on Wednesday, Nov 20 of 2013 and I plan to update throughout for those who may be interested. In July 2014, Mrs. Delouise Johnson was picking figs in her backyard, […] I had ankle surgery to repair my medial malleolus back on May 8. In the ankle, medial and lateral talar lesions required surgery in 20 of 61 (32.8%) and 6 of 19 (31.6%) lesions, respectively, while central talar lesions and tibial plafond lesions failed conservative treatment in 1 of 3 and 0 of 2 lesions (Table 3). Microfracture knee surgery success rate. He uses the Oxford Partial Knee and says it is the best one to go with. Any and all answers are greatly appreciated! Zwingmann et al46 performed a systematic review of 54 studies and 1105 patients and concluded that in terms of recommended procedures for ankle OCD, “with over 1100 included patients in the present study, no strong recommendations based upon scientific evidence can be given.” Our study confirms that the surgical choice to address OCD of the ankle remains variable. In this study, we found surgical progression in knee OCD—the most common location for OCD—was nearly equal to that of the group as a whole, progressing 33.5% of the time versus 35.3% of the time for the group as a whole. I am now facing a microfracture and a Brostrom is about a month. Long-term studies on the modified-Brostrom procedure show 85-95% success rates. It is important for the healing process and the operative result to start targeted physiotherapy exercises for the ankle early. As opposed to OCD of the ankle and knee, loose body removal was also frequently performed (63.6%). The same lesion showed up on MRI/CT, about 1.1 cm x .6 cm still partially attached but with fluid gathering beneath it. Please check you selected the correct society from the list and entered the user name and password you use to log in to your society website. In January of this year I stupidly jumped off a rock on a hike and sprained it more severely, likely magnifying an already existing OLT. Find out about Lean Library here, If you have access to journal via a society or associations, read the instructions below. For the group as a whole, most patients had only 1 surgery (109/115, 94.8%), while 3 patients each had 2 (2.6%) and 3 surgeries (2.6%). OCD usually causes pain during and after sports. I can't contract my foot upwards past the 90 degree position. In the multivariable logistic regression analysis, patients aged 12 to 19 years were significantly more likely to progress to surgery than 6- to 11-year-olds for OCD of all locations combined (OR, 8.25; 95% CI, 3.57-19.10; P < .0001) and OCD of the knee only (OR, 7.44; 95% CI, 2.89-19.21; P < .0001). Overall, 317 patients with a total of 334 OCD lesions were found. In the cases that were revised to an ankle fusion, 81% fused after their first fusion procedure. And so I reverted to non weight bearing, hopping around everywhere on crutches.At my post op review I saw a podiatrist and voiced my concerns that I could not yet walk and was still feeling pain. Ended up in hospital from pain meds impacting me for 4 days. New MRI was good, but with the high powered system, my ankle was in bad shape - felt like it knocked something loose in the joint. Progression to surgery was noted and the surgical technique recorded for each patient. LOL. The literature is sparse regarding surgical progression of OCD of the elbow. The authors declared that they have no conflicts of interest in the authorship and publication of this contribution. Any other significant pathology that exists may also need to be addressed at the time of surgery. Similarly, in our cohort, just over half of the elbow lesions progressed to surgery. Has anyone had both procedures together and what was your experience? Similar to the recommendations of multiple authors,12,14,23,30,35,36,41,42 a large number of surgeries performed in our series to treat OCD of the elbow were marrow stimulation techniques, including chondroplasty/debridement (81.8%), drillings (45.5%), and microfracture (27.3%). Although I always had a less than fantastic ankle and some arthritis through the years, it was not until this summer that I went back to an OS due to shooting pain and locking in the ankle. For OCD of the ankle, progression to surgery was 38.5% among females and 21.2% among males, which, despite the difference, was not statistically significant (P = .25). This seems to be counterintuitive that this will still work? This forum has really helped me come to an understanding of my ankle, and hopefully I can pay it forward. Unfortunately, due to the retrospective nature of this study, we do not know attrition rates for the patients in this study, making it difficult to draw too many conclusions in terms of revision surgeries. Prior to this work, the most comprehensive studies on OCD progression to surgery came from Hefti et al20 and Lefort et al.31, In 1999, Hefti et al20 and the European Pediatric Orthopedic Society provided the largest study of pediatric OCD of the knee and progression to surgical intervention. Last of all, the present study does not specifically address the success of surgery, although 95% of patients did not require any further surgery after follow-up of at least 2 years. Will I be provided with an air boot or something or is there any ideas as to how to protect it?After the 6 weeks NWB what happens? It is hurting again now, although been ok for the last week and a half. Foot Ankle Int.2018 Nov;39(11):1257-65. It depends on the site of the lesion." Ankle fusion is a surgical procedure that's performed for the treatment of severe ankle arthritis. Please read and accept the terms and conditions and check the box to generate a sharing link. I hate it. It also demonstrates that approximately one-third of pediatric patients with OCD as a whole and of the ankle and knee specifically progress to surgery, with a higher progression in elbow OCD patients. I'm now wondering if I screwed the microfracture up. This also is well described in the literature.3,23,45 Surgery may be required more often in the treatment of OCD of the elbow due to presentation of the lesions in older patients at a higher, less stable grade. My doctor and I are both hopeful that this will give me some time to make this big decision. I've been doing PT, yoga and general strengthening for about a month. Members of _ can log in with their society credentials below. My doctor said that I am still bone on bone and will need a partial knee replacement. I'm suppose to be NWB for 6 weeks post op and as of Monday wearing my aircast 24/7 except for showering. OATS, BMS and ACI scored success rates of 87, 85 and 76%, respectively. Does anyone have experience with this? Although this was not a natural history or epidemiologic study in a closed population, it did assess progression to surgery, among other things, in a large multicenter study. Retrograde drilling and fixation scored 88 and 89%, respectively. As an orthopaedic surgeon specializing in treating OCD lesions in children, not all treatments are 100% successful. Knee :: Microfracture Surgery With Allograft Transplantation Done? Laboratory and clinical work continue in this area; Other Procedures. Of the 334 OCD lesions, 206 lesions (61.7%) were in the knee, 85 lesions (25.4%) were in the ankle, 40 lesions (12.0%) were in the elbow, 2 lesions (0.6%) were in the shoulder, and 1 lesion (0.3%) was in the foot (Table 2). I had my first post op this past Monday and the stitches were removed. Has anyone had the same? You can be signed in via any or all of the methods shown below at the same time. In addition, this work provides a benchmark with which to compare treatment and intervention, with the goal of decreasing the need for surgical intervention in the future for this pathology. All I want to do is get better so I can get to work, but I work at a factory and I stand on my feet 8 to 12 hours a day 6 to 7 days a week. He called me back himself and said he already had the results of the MRI and he now felt comfortable recommending re-doing the microfracture/debridement again over the cadaver implant. Create a link to share a read only version of this article with your colleagues and friends. Methods: Study subjects included one hundred five patients (73 males and 32 females) with osteochondral ankle injuries diagnosed by plain radiographs and magnetic resonance imaging. This study confirms a worse prognosis in the nonoperative treatment of older patients with OCD. I had Microfracture Knee surgery on January 12, 2016 and it was not a success. Given the dearth of information describing the prevalence of surgical intervention in the treatment of OCD in pediatric patients, the purpose of this article is to describe the incidence of surgical intervention in relation to specific risk factors among patients with OCD. Aug 24, 2014. ASAP and I'm fearful this will slow my progress to a crawl! I followed directions religiously.I did notice that when I pressed on certain areas of the foot, I would feel a sharp pain. When the right criteria are met, however, "the success rate is really pretty high, 75 to 85 percent. For the knee as a whole, right-sided lesions failed conservative treatment 29.4% of the time and left-sided lesions 38.9% of the time. He was going to send me to someone who specialized in cadaver plants - but first - a new MRI. Yesterday while doing ROM, was flexing foot up and down and went a little further than I prob should have when flexing it towards my body, I felt I was strong enough to move it further but apparently that was a very bad idea because it immediately hurt very bad at the site of the OCD (or at least where I think it was - medial) and it's been achy there ever since. So I had ankle arthroscopy with microfracture for an OCD in my left ankle on 13 Apr 16. I had microfracture/debridement for an ankle OCD of the medial talar dome of my right ankle at the end of April 2010. I was completely unable to move my ankle upwards.Currently (4 weeks since the operation) from a starting position of a 90 degree angle from leg to foot, i can move my foot down and up back to the 90 degree position without any discomfort. when much more than a little pressure on the foot results in this nerve pain!Help! i'm non-weight bearing for 6 weeks but I feel really vulnerable with my foot just in crepe bandages. Postoperatively, patients use a … Kocher, MS, Czarnecki, JJ, Andersen, JS, Micheli, LJ. And finally, any diabetics out there that have had this surgery? The doctor is useless. A number of other studies on smaller numbers of patients have evaluated surgical results in OCD of the knee, ankle, and elbow, with mixtures of adult and pediatric patients.1,2,4–8,10. The knowledge of likelihood of progression to surgery of OCD by location, sex, and age is useful in counseling patients and in planning treatment. Manuscript content on this site is licensed under Creative Commons Licenses, The Incidence of Surgery in Osteochondritis Dissecans in Children and Adolescents, http://www.creativecommons.org/licenses/by-nc-nd/3.0/, https://us.sagepub.com/en-us/nam/open-access-at-sage. It may be that stable OCD in the skeletally mature population is less symptomatic and therefore less recognized, but proof of this is beyond the scope of this particular project and is an excellent future research question. What are the possible complications and risks of this procedure? The types of surgeries performed in this study are summarized in Table 5. TABLE 5 Types of Osteochondritis Dissecans Surgerya, Progression to surgery for OCD of the knee, elbow, and ankle strongly correlated with patient age at the time of diagnosis. Did it eventually get better? The surgery usually is done under a general anesthetic. Surgery was more likely when the lesion was sclerosing or “dissected,” if the patient was older with growth plates closing or closed, and if the lesion was anywhere other than the lateral aspect of the MFC.20, In 2006, Lefort et al31 studied 892 cases of OCD of the knee in a mixture of adults and children. TABLE 3 OCD Lesion Location and Progression to Surgerya. Some of the mechanisms that control healing after traumatic injury may play a role in the healing of OCD lesions as well. This site uses cookies. If you have access to a journal via a society or association membership, please browse to your society journal, select an article to view, and follow the instructions in this box. Ankle replacement fact #1: Success rates are promising. 10 days sounds VERY optimistic from what I've read online. Saw in order to allow access to ) and they are going great pain. 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Home on winter break as well with surgery or live with the surgeon in four weeks time questions! Atomizer procedure results - success rate confirms a worse prognosis in the process! Different in progression toward surgery were examined using this multivariate logistic regression analysis 'd try recount. First - a ocd ankle surgery success rate MRI years ago and still have chronic heel pain, may!