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- Talk
- 23/09/2021
- UK
Loose Body in the Adolescent’s Knee. When to Operate and the Role of Fixation
Description
In this lecture, Dr. Joanna Thomas elaborates on the management of loose bodies in the adolescent knee, emphasizing their unique healing capabilities compared to adults. She discusses the importance of understanding the cellular environment of children, highlighting their higher expression of chondrocyte markers and a greater quantity of mesenchymal stem cells. Despite these advantages, Dr. Thomas addresses the lack of evidence supporting improved healing of articular cartilage defects in children and the differences in osteochondral junctions between adults and adolescents.
The talk outlines the etiology of injuries, primarily stemming from traumatic events like patella dislocation or atraumatic causes such as osteochondritis dissecans, and stresses the role of MRI in accurately diagnosing these conditions for proper treatment. Dr. Thomas also covers crucial factors for consideration during surgery, including alignment, meniscus preservation, stability of cruciate ligaments, and maintaining normal vitamin D levels.
She highlights that management strategies for children do not differ significantly from those for adults and discusses techniques such as arthroscopy, fixation, and stabilization of osteochondral lesions. Furthermore, her recommendations caution against microfracture techniques in certain circumstances, while advocating for options like osteochondral autograft transplantation and appropriate follow-up post-surgery. The session emphasizes the need to treat children promptly and consider their anatomical differences when making clinical decisions.