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Case Report



A MODERN TREATMENT OF BILATERAL OSTEOCHONDRITIS DISSECANS IN KNEES: FROM A CASE REPORT TO LITERATURE'S REVIEW

Marco Corzani, Luigi Meccariello, Michele Bisaccia, Pellegrino Ferrrara, Giuseppe Rinonapoli, Luigi Piscitelli, Maria Liberata Meccariello, Auro Caraffa.




Abstract
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Background
Osteocondrithis dissecans (OCD) is an acquired disease due to a subcondral bone ischaemia that affects generally the medial femoral condyle as well as above lying cartilage.
Though the incidence of OCD is only 6/10,000 in the general population, in the later stages of disease, OCD fragment can break off inside the articular cavity it is the most Frequently reported cause of free endoarticular body.
The etiology has been hypothesized as being multi-factored due to traumas or
microtraumas along with metabolic, endocrine and genetic disorders leading to subchondral ischemia .
Description of case
A 15-year old male amateur soccer player presented to our department complaining of recurrent episodes of pain at rest in both knees, swelling and articular blockage occurring over the past 3 years. RX and MRIrevealed bilateral lesions on both medial condyles.
A ONE-STEP surgical technique was performed that incorporated the drawing of
mesenchymal staminal cells (MSCs) and their implantation.

Conclusion

This case report deals with a rare case of bilateral OCD of the knee treated with the latest technique in regenerative medicine. At 6-month follow up there was a complete return of muscular tonality in both knees andthe patient was allowed to return to light physical activity. These results are noteworthyfor the fact they were obtained from a combined surgical approach that when compared toalternative approaches lead to a shorter hospital stay and a reduced hospital burden. Each of the osteochondral lesions was evaluated from imaging results and arthroscopic findings.

Key words: Mesenchymal Stem Cells; Osteocondrithis dissecans; ICRS Classification; Bone Marrow Concentration, Knee, Arthroscopic; Scaffold






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