Arthroscopy of the knee joint in the diagnosis and follow-up observation of osteochondritis dissecans.

Arthroscopy of the knee joint in patients with osteochondritis dissecans provides useful information that cannot be obtained by previously available examination techniques, both in the diagnostic work-up and in follow-up examinations. Thus, on the one hand, primary arthroscopy makes it possible to arrive at a relatively certain decision as to the therapeutic measures to be adopted, without the need for exploratory arthrotomy while, on the other hand, follow-up arthroscopy permits the effectiveness of the selected therapeutic measures to be examined. As a result, it becomes possible, at an early stage, to adopt other measures when revision of the therapy is required, even when the need for this has not yet become apparent either clinically or radiologically. Follow-up arthroscopy in the case of patients treated conservatively is indicated after 4 and 8 months, since in these cases, surgical procedures can be adopted where indicated. Our experience to date indicates that arthroscopic follow-up examination carried out 4 months postoperatively is too early. Only after about 8 months are visible changes of the cartilage that permit a prognosis with respect to the healing-in of the osteochondral fragment, can be expected. Further investigations should be carried out to determine whether, as some of our last arthroscopic examinations suggest, reparative processes in the region of chondromalacial changes can occur more than one year postoperatively.