Osteochondritis dissecans of the knee with loose fragments. Treatment by replacement and fixation with readily removed pins.

We reviewed six patients with a five to fifteen-year follow-up and a seventh with shorter follow-up who underwent replacement and fixation with easily removable pins of large osteocartilaginous fragments resulting from osteochondritis dissecans. Excellent or good results were achieved in all but one patient. Preparation of the fragments to fit into their vascularized beds prior to internal fixation is advisable, and in some cases the bed should be partially filled with cancellous bone before the fragments are replaced. Immobilization is prescribed until the pins are removed three to six weeks after surgery. Weightbearing is delayed until there is roentgenographic evidence of beginning union of the fragment to the underlying bone.