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Retro-articular Drilling

Trans-articular Drilling
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Retro-articular:

Video:

This video describes a case of juvenile OCD and the associated diagnostic, operative, and post-operative procedures and protocols.

Powerpoint:

“Outcomes of extra-articular,
 intra-epiphyseal drilling for OCD lesions of the knee with intact articular cartilage”

Eric W Edmonds, MD, Jay Albright, MD
, Scott J Mubarak, MD, 
Tracey Bastrom, MA, 
Henry G Chambers, MD
[ilink style=”download” url=”http://18.222.7.151/wp-content/uploads/2012/10/OCD-Drilling-Chambers.ppt”]Download Powertpoint Presentation[/ilink]

Procedure:

–        Drilling must be performed under AP and lateral fluoroscopic guidance, as described by Edmonds et al. and Boughanem et al., with no additional drilling in ‘trans-articular’, or intra-articular trans-condylar fashion

–        Use of a 0.062 K-wire for drilling

–        Minimum of 4 wire passes per square centimeter (to insure adequate disruption of sclerotic bone margin of OCD lesion) with no maximum number of wire passes (as additional wire passes are not theorized to be disruptive to the health of the articular cartilage, as described in previous techniques) Top
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Trans-articular:

Procedure:

–        Drilling under arthroscopic visualization, directly through the articular cartilage, with no additional drilling in ‘retro-articular’, ‘extra-articular’, or trans-condylar (through the intercondylar notch) fashion

–        Use of a 0.045 K-wire for drilling

–        A minimum 4 wire passes per square centimeter (to insure adequate disruption of sclerotic bone margin of OCD lesion), with a maximum of 5 wire passes per square centimeter (to prevent unnecessary disruption of the articular cartilage) Top