PMC4714482_01
Image examinations at initial visit. a A posterior-anterior weight-bearing radiograph (Rosenberg's view) at initial visit. An irregular radiolucent lesion with surrounding sclerosis is identified in the epiphyseal region. b, c T1-weighted sagittal magnetic resonance imaging images at first visit. An area of low signal intensity at the periphery of subchondral bone contour is present in the lateral femoral condyles of the patient's right (b) and left (c) knees
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Fig1
These lesions were classified as Stages I and II by Hefti's classification for the right and left knees respectively (Figs. 1a-c), and stage I by Bohndorf's classification.
Image examinations at 6 months after the initial visit. a A posterior-anterior weight-bearing radiograph (Rosenberg's view) of the patient's left knee after 6 months of conservative treatment. b T1-weighted sagittal magnetic resonance imaging image. The osteochondritis dissecans lesion is evident
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Fig2
In addition to sports activities in his primary school, he had been practicing figure skating 5 days a week for 2 years. The radiograph at 6 months after the initial visit showed no apparent healing (Fig. 2).
Fluoroscopic view during transplantation of the osteochondral graft
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Fig3
During the harvest and transplantation procedures, we repeatedly checked the direction and distance from the growth plate on intraoperative fluoroscopic images (Fig. 3).
T1-weighted sagittal magnetic resonance imaging images at 1 year and 3 months after the second surgery. a Lateral femoral condyle of the patient's right knee following transchondral drilling. b Medial femoral condyle of his right knee following transchondral drilling. c Lateral femoral condyle of his left knee following cylindrical osteochondral grafting. d Graft donor site in the lateral femoral condyle
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Fig4
MRI at 1 year and 3 months after reoperation showed findings indicative of healing in his bilateral knees (Figs. 4a-c).
A posterior-anterior weight bearing radiograph (Rosenberg's view) of the patient's left knee at 3 years and 6 months after reoperation showing radiological healing of the osteochondritis dissecans lesions in both knees
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Fig5
In addition to sports activities in his primary school, he had been practicing figure skating 5 days a week for 2 years. The final follow-up evaluations at 3 years and 6 months after the second surgery showed no abnormal findings in a physical examination with complete healing of the subchondral bone lesion in the radiograph (Fig. 5).