Journal of Pediatric Orthopaedics最新文献

{"title":"Serum Titanium Levels Remain Elevated 6 Years and Beyond From Spinal Instrumentation in Children.","authors":"Peter J Cundy, Georgia Antoniou, Jennie Louise, William Cundy","doi":"10.1097/BPO.0000000000002954","DOIUrl":"https://doi.org/10.1097/BPO.0000000000002954","url":null,"abstract":"<p><strong>Background: </strong>Paediatric spinal implants are known to cause circulating metal ions. A previous prospective study by the authors demonstrated elevated chromium, cobalt, nickel, and especially persistence of titanium serum levels at a median of 5.4 times baseline level.</p><p><strong>Methods: </strong>A continuation of prospective study of children undergoing spinal deformity surgery with repeated testing for circulating metal ions including preoperative levels as controls. Thirty-four of 56 participants returned beyond 6 years from surgery for testing for circulating metal ions using high-resolution inductively coupled plasma mass spectrometry. Linear mixed effects models adjusting for repeated measurements over time were used to analyse titanium, chromium, cobalt, and nickel serum levels.</p><p><strong>Results: </strong>Median titanium levels at 6 years decreased significantly to 0.46 times that of 2-year levels (95% CI: 0.32-0.67, P<0.001); however, they remained 2.40 times higher compared with the presurgery control levels (95% CI: 1.47-3.92, P<0.001). In comparison, median chromium levels at 6 years were significantly increased from 2 years (1.45 times) but were not significantly different to baseline (1.13 times). Cobalt levels at 6 years remained significantly higher than baseline (1.32 times), but also decreased significantly compared with 2-year levels (0.76 times). Nickel levels at 6 years did not differ significantly from baseline or from 2-year levels.</p><p><strong>Conclusions: </strong>Titanium remains raised at beyond 6 years from spinal instrumentation in children. The effects on a person's health through deposition in solid organs including the brain or on the offspring of persons with spinal instrumentation remains unclear. Curiously, chromium levels increased at 6-year sampling in \"all titanium\" constructs which may be explained by metallurgical irregularities.</p><p><strong>Level of evidence: </strong>Level II.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Coronal and Sagittal Vertebral Balance is Affected by the Severity of the Disease in Pediatric Patients with Cystic Fibrosis: A Pulmonary Function Test-Based Cross-Sectional Study.","authors":"Yavuz Şahbat, Mine Yüksel Kalyoncu, Mert Gündoğdu, Almala P Ergenekon, Yasemin Gökdemir, Ela Erdem Eralp, Bülent Karadağ, Ahmet H Akgülle","doi":"10.1097/BPO.0000000000002947","DOIUrl":"https://doi.org/10.1097/BPO.0000000000002947","url":null,"abstract":"<p><strong>Background: </strong>Although cystic fibrosis (CF) mainly affects the respiratory and gastrointestinal systems, it may frequently present with musculoskeletal manifestations including bone fractures, low bone mineral density, and spinal pathologies. Assessment of spinal pathologies in CF patients is of vital importance because the effects on lung capacity and spinal posture are clearly defined.</p><p><strong>Questions/purposes: </strong>The frequency of vertebral pathologies in CF patients has yet to be determined. The aim of this study was to investigate the frequency of scoliosis and hyperkyphosis and the relationship of coronal, sagittal, and spinopelvic parameters with disease severity in CF patients.</p><p><strong>Methods: </strong>Patients were tested with forced expiratory volume in 1 second (FEV1), dual-energy x-ray absorptiometry (DEXA), and full spine radiographs. Measurements were taken of the major coronal curve in the coronal plane, cervical and lumber lordosis, thoracic kyphosis, and C7 plumb line values. Patients were categorized into 3 groups based on the FEV1 values (severity) from respiratory function tests (severe: group 1 FEV 1≤40, moderate: group 2 FEV1 40 to 80, mild: group).</p><p><strong>Results: </strong>This cross-sectional study included 208 CF patients aged 5 to 21 years. The rates of scoliosis and thoracic hyperkyphosis were 31% (n=64) and 24% (n=50), respectively. The highest rates of scoliosis (63%) and thoracic hyperkyphosis (56%) were found in the severe CF group (P=0.016 and P=0.006, respectively). FEV1 and thoracic kyphosis were weakly and inversely but significantly correlated (rho: -0.200 and P=0.004). There was no difference in BMD between patients with and without scoliosis and between patients with and without hyperkyphosis. There was no significant difference in DEXA Z-score between patients with and without hyperkyphosis. The L1-L4 DEXA Z-score of patients without scoliosis was significantly higher (P=0.017).</p><p><strong>Conclusions: </strong>Scoliosis and hyperkyphosis were more prevalent in the severe CF patients group, although the proportion of patients requiring treatment was relatively low. Understanding the relationship between disease severity and coronal and sagittal spinal balance, and spinopelvic parameters is crucial, as it guides the early detection and management of scoliosis in CF patients.</p><p><strong>Level of evidence: </strong>Level II.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complication Rates Following Tibial Tubercle Osteotomy With and Without Distalization in Young Patients With Patellar Instability: A Multicenter Study.","authors":"Akbar N Syed, Kevin J Orellana, David Kell, Alexandra Dejneka, Amin Alayleh, Neeraj M Patel, J Todd R Lawrence, Theodore J Ganley, Brendan A Williams","doi":"10.1097/BPO.0000000000002945","DOIUrl":"https://doi.org/10.1097/BPO.0000000000002945","url":null,"abstract":"<p><strong>Background: </strong>Tibial tubercle osteotomy (TTO) is a surgical procedure for the management of patellofemoral instability (PFI). Tubercle distalization requires a complete osteotomy detachment and has been shown to have an increased rate of certain complications in predominantly adult cohorts. With this study we identify and compare the complication rate of 2 TTO techniques-anteromedializing alone (AM) and anteromedializing with concomitant distalization (AMD) among young patients.</p><p><strong>Methods: </strong>A retrospective comparative study was conducted from 2010 to 2021 at 2 large tertiary care pediatric hospitals identifying adolescent and young adult patients (<21 years) who presented for surgical treatment of PFI undergoing TTO. Groups were stratified based on the type of TTO: AM and AMD. Demographics and radiographic measures were recorded. Postoperative complications were identified and recorded using the modified Clavien-Dindo-Sink (CDS) classification system. Bivariate testing was conducted to compare variables among treatment groups.</p><p><strong>Results: </strong>Seventy-six knees undergoing tubercle osteotomy (47 AM and 29 AMD) were identified. Treatment cohorts had similar demographics, mean preoperative CDI, Oswestry-Bristol classification, and Dejour classifications. Median follow-up was similar between both the groups in the AM and AMD groups (P=0.5). The overall complication was 22% (n=17/76) whereas in the AM group and AMD group was 19% (n=9/47) and 27% (n=8/29), respectively (P=0.57). The most common complications observed in both groups were infection and arthrofibrosis. No significant differences between AM and AMD groups were noted with respect to the grade of complication and individual complication rates (P >0.05).</p><p><strong>Conclusion: </strong>The rate of overall complications was similar to prior adult studies. In this large adolescent cohort, tubercle distalization compared with anteromedial transfer alone did not demonstrate statistically significant differences. Findings from this study help surgeons understand complication rates and improving counselling among adolescent PFI patients being considering for a distalizing TTO.</p><p><strong>Study design: </strong>Retrospective comparative study; level of evidence III.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Surgical and Conservative Treatments for Gartland Type II Supracondylar Humerus Fractures: Evaluation of the Need for Surgical Treatment: Comment on Study by Güneş et al.","authors":"Aravind Balachandran, Siddharth Jain, Sourabh Kumar Sinha, Prateek Behera, Sonal Mishra","doi":"10.1097/BPO.0000000000002951","DOIUrl":"https://doi.org/10.1097/BPO.0000000000002951","url":null,"abstract":"","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Developing Perthes Disease: A Comprehensive National Analysis Spanning 2 Decades.","authors":"Tanya Boghosian, David Momtaz, Jad Lawand, Jacob Jahn, Blaire Peterson, Abdullah Ghali, Pooya Hosseinzadeh","doi":"10.1097/BPO.0000000000002914","DOIUrl":"https://doi.org/10.1097/BPO.0000000000002914","url":null,"abstract":"<p><strong>Background: </strong>Perthes disease is an uncommon pediatric condition affecting the hip joint, causing varying degrees of femoral head necrosis. The underlying cause of Perthes remains unknown, thus it is crucial to identify risk factors associated with its development to aid in early diagnosis and intervention. This study aimed to analyze risk factors associated with Perthes in a large cohort.</p><p><strong>Methods: </strong>A case-control study was conducted using data from a U.S. national database from 2003 to 2023. Patients diagnosed with Perthes were compared with those without the disease. Variables potentially associated with Perthes were analyzed using multivariable logit models, and adjusted odds ratios (AOR) with 95% CI were calculated. Statistical significance was determined, and a P-value <0.05 was considered significant.</p><p><strong>Results: </strong>The study included 4034 patients with Perthes and 3,483,745 age-matched controls. The mean age of patients with Perthes was 8.38 years, compared with 8.35 years in the control group (P=0.27). Significant risk factors identified included male sex (AOR: 3.14, P<0.001), white race (AOR: 2.16, P<0.001), and obesity (AOR: 2.21, P<0.001). Conversely, Black (AOR: 0.26, P<0.001), Hispanic (AOR: 0.53, P<0.001), and Asian (AOR: 0.55, P<0.001) races were associated with lower odds of developing Perthes. Additional significant risk factors included tobacco exposure (AOR: 1.25, P=0.02), hypertension (AOR: 1.64, P<0.001), and thrombophilia (AOR: 9.17, P<0.001).</p><p><strong>Conclusions: </strong>This study is the largest study on Perthes disease in literature, identifying several independent risk factors, including male sex, white race, obesity, tobacco exposure, hypertension, obesity, and thrombophilia. Among children with Perthes, thrombophilia exhibited the highest adjusted odds ratio, despite its rarity. These findings offer valuable insights for further research aimed at elucidating the underlying etiology of Perthes disease, particularly with regards to the roles of vascular and metabolic pathways.</p><p><strong>Level of evidence: </strong>Level III-prognostic case-control study.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Outcomes at Skeletal Maturity After Physeal-sparing Procedures for Early-onset Slipped Capital Femoral Epiphysis Using a Long Screw With a Short-threaded Tip.","authors":"Kwang Ryeol Lee, Whei Jun Kim, Wonik Lee, Chang Ho Shin, Tae-Joon Cho, In Ho Choi, Mi Hyun Song","doi":"10.1097/BPO.0000000000002942","DOIUrl":"https://doi.org/10.1097/BPO.0000000000002942","url":null,"abstract":"<p><strong>Background: </strong>Physeal-sparing procedures are preferred for treating early-onset slipped capital femoral epiphysis (SCFE), reducing limb-length discrepancy (LLD), and femoroacetabular impingement (FAI). This study aimed to investigate the treatment outcomes after physeal-sparing procedures for early-onset SCFE.</p><p><strong>Methods: </strong>We reviewed medical and radiographic records of SCFE patients from 1992 to 2022. Patients under 11 years old and followed up to skeletal maturity were included. Physeal-sparing procedures using a long screw with a short-threaded tip were performed in patients with mild to moderate slips since 2008. Patients were dichotomized into physeal-sparing and traditional in situ fixation (ISF) groups. Radiographic and clinical outcomes were comparatively analyzed between the groups.</p><p><strong>Results: </strong>Fifteen patients underwent physeal-sparing procedures, whereas 12 patients underwent traditional ISF. There was no further slippage in either group. During follow-up, slip angle was significantly decreased in the physeal-sparing group compared with the traditional ISF group (22.0 vs. 8.8 deg, respectively, P<0.01). LLD of>20 mm did not occur in the physeal-sparing group, but was observed in the traditional ISF group (P<0.01). Femoral neck length (FNL), articulo-trochanteric distance (ATD), α angle, and femoral head-neck offset of the physeal-sparing side were comparable to the unaffected healthy side (P=0.08, P=0.25, P=0.14, P=0.13), but differences were seen in healthy versus traditional ISF sides (P<0.01, P<0.01, P<0.01, and P<0.01, respectively). In addition, consistent growth was observed in the physeal-sparing side, but premature physeal arrest developed in the traditional ISF side. Six physeal-sparing patients required screw change procedures as the proximal femur outgrew the screw. The physeal-sparing group scored higher modified Harris Hip Score points than the traditional ISF group (89.5 vs. 85.3, respectively).</p><p><strong>Conclusions: </strong>Using a long screw with a short-threaded tip can stabilize the proximal femoral physis. It may also allow the continual growth and remodeling of the proximal femur in the treatment of early-onset SCFE.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes Following Surgery for Congenital Dislocation of Knee: Comment on the Study by Honcharuk et al.","authors":"Erin M Honcharuk, Kelly A Jeans, Jordan L Polk, Charles E Johnston","doi":"10.1097/BPO.0000000000002935","DOIUrl":"https://doi.org/10.1097/BPO.0000000000002935","url":null,"abstract":"","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Screw Size or Configuration Affect Hardware Removal Rate in Surgically Treated Tibial Tubercle Fracture.","authors":"Anthony Dure, Jared A Nowell, Ryan M Antar, Evan Sheppard, Syed Ahmed, Md Sohel Rana, Emily Niu","doi":"10.1097/BPO.0000000000002944","DOIUrl":"https://doi.org/10.1097/BPO.0000000000002944","url":null,"abstract":"<p><strong>Background: </strong>Displaced tibial tubercle fractures in adolescent patients typically require surgical management. There is limited research on the relationship between fracture type, screw construct, and clinical outcomes. Symptomatic screws and the need for screw removal are suggested to be associated with larger screw size. The purpose of this study is to investigate the impact of screw size and fixation construct on treatment outcomes and the risk of symptomatic hardware.</p><p><strong>Methods: </strong>Tibial tubercle fractures treated at a level I pediatric trauma center from January 2010 to December 2022 were retrospectively reviewed. Three groups were defined based on the largest screw size used for fixation (small: <5.0, medium: 5.0 to 6.0, large: >6.0 mm). Bivariate statistics were used to evaluate associations between screw size, patient demographics, and fracture treatment. The primary outcomes studied were rates of postoperative symptomatic hardware, symptomatic hardware removal, and fracture displacement. Univariate and multivariate logistic regression analyses were used to identify independent predictors of symptomatic hardware and symptomatic hardware removal.</p><p><strong>Results: </strong>One hundred eighty-two knees in 168 patients were included. The mean age was 14.5 years (SD: 1.4 y), 94.5% male. Screw size distribution was small in 26 knees (14.3%), medium in 83 (45.6), and large in 73 (40.1%). Screw size was significantly different among the Ogden types (P<0.001). Forty-one patients (22.5%) had symptomatic hardware, and 31 (17%) underwent removal of hardware at a median of 11 months postoperative. Rates of symptomatic hardware were not statistically different in the screw size groups (P=0.184). Screw size, number, and washer use were not associated with risk of symptomatic hardware or removal in multivariate analysis.</p><p><strong>Conclusion: </strong>Symptomatic hardware following operatively treated tibial tubercle fractures is common, occurring in ∼1 out of 5 patients. Fracture type, screw size and number, and fixation construct were not associated with increased risk of symptomatic hardware. Surgeons should counsel patients on the potential for symptomatic hardware and secondary removal procedures, but this should not limit their choice of fixation construct.</p><p><strong>Level of evidence: </strong>Level III-retrospective, therapeutic study.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior Hemivertebra Extended Resection Combined With Concave Anterior Column Reconstruction for Congenital Scoliosis.","authors":"Chengkun Zhao, Shijie Wang, Hegang Niu, Jingjing Zhang, Kun Yang, Hui Tao, Cailiang Shen, Yinshun Zhang","doi":"10.1097/BPO.0000000000002941","DOIUrl":"https://doi.org/10.1097/BPO.0000000000002941","url":null,"abstract":"<p><strong>Background: </strong>Posterior hemivertebra resection for hemivertebra deformities has been widely reported. However, achieving adequate correction of deformities through conventional hemivertebra resection remains technically challenging in older children. The authors developed a technique combining posterior hemivertebra extended resection with concave anterior column reconstruction. This study aimed to evaluate the outcomes of the modified posterior hemivertebra resection (MPHR) technique in older children with rigid congenital scoliosis.</p><p><strong>Methods: </strong>A retrospective analysis was conducted from June 2016 to February 2023 on 15 patients with congenital scoliosis, all of whom were over 10 years old and had less than 30% flexibility. They underwent posterior hemivertebra extended resection combined with concave anterior column reconstruction. The medical records and radiographs were reviewed to evaluate correction results and complications.</p><p><strong>Results: </strong>There were 7 males and 8 females with a mean age of 12.9±1.5 years. The mean follow-up time was 2.0±0.4 years. The segmental curve was 41±11 degrees preoperatively, 7±4 degrees postoperatively, and 8±4 degrees at the final follow-up, resulting in a correction rate of 80%. The segmental kyphosis improved from 41±26 to 7±7 degrees, resulting in a correction rate of 83%. The correction rate for the compensatory cranial and caudal curve were 59% and 66%, respectively. There was one superficial wound infection postoperatively.</p><p><strong>Conclusions: </strong>The MPHR provides satisfactory correction of hemivertebra deformity in older children. The MPHR represents an alternative technique for older children with rigid curves.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteochondral Autograft Transplantation for Symptomatic Full-thickness Patellar Cartilage Defects in Adolescents.","authors":"Javier Masquijo, Miguel Carabajal Mattar, Alejandra Ron Marqués, Alberto Losa, Juan Cabello Blanco, Joaquín Nuñez de Armas, Maria J Tuca","doi":"10.1097/BPO.0000000000002850","DOIUrl":"10.1097/BPO.0000000000002850","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to review the clinical, radiographic, and magnetic resonance imaging (MRI) outcomes of osteochondral autograft transplantation applied to patellar cartilage lesions of patients under 18 years of age.</p><p><strong>Methods: </strong>Data from nine consecutive patients were retrospectively analyzed for indications, preoperative complications, and clinical-radiographic outcomes. Patients were clinically evaluated using the Pedi-IKDC and Lysholm scores. In addition, return to sports and knee pain were assessed. MRI evaluation included an analysis of osteochondral graft integration using the magnetic resonance observation of cartilage repair tissue 2.0 score and radiographic classification of osteoarthritis using the Kellgren-Lawrence system.</p><p><strong>Results: </strong>Nine patients (9 knees, 6 males) with a mean age of 14 years (SD: 1.7, range; 11 to 17 y) were analyzed. Lesions were located on the medial facet (N=5), lateral facet (N=3), and central ridge of the patella (N=1). One or 2 cylindrical osteochondral grafts were transplanted, with a median diameter of 9 mm (range: 8 to 10 mm). The average lesion size was 102.9 mm 2 . At a mean follow-up of 45.1 months (range: 23 to 117 mo), the mean Pedi-IKDC score was 89.2 (SD: 9.8), and the Lysholm score was 94.4 (SD: 4.8). Patients returned to sports in an average of 7.3 months (SD: 2, range: 6 to 12 mo). MRI of 8 patients showed osteochondral graft integration with a mean magnetic resonance observation of cartilage repair tissue 2.0 score of 86.9 (SD: 7, range: 80 to 100). Six knees showed Kellgren-Lawrence grade 0 joint space on radiographs, and 3 showed grade 1. Eight patients were asymptomatic at the last follow-up, and 1 reported occasional mild pain with intense physical activity. One patient developed arthrofibrosis, requiring arthroscopic lysis of adhesions and manipulation.</p><p><strong>Conclusion: </strong>Osteochondral autograft transplantation is a safe and effective technique for treating symptomatic patellar full-thickness chondral lesions in adolescents. Long-term follow-up studies will determine whether the affected area maintains structural and functional integrity over time.</p><p><strong>Level of evidence: </strong>Level IV-therapeutic study.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"152-157"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}