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The following case report describes the medical course of osteochondritis dissecans (OD). The 26-year-old patient has been complaining of load-dependent pain in the knee joint for months. A few days before the examination, the patient also suffers from symptoms of entrapment and restricted movement. The radiograph and MRI show OD with a free joint body and empty mouse bed. During surgery, the free joint body – despite being thin and subchondral – is grasped and refixed into its bed with the help of the bone screw graft. The protruding part of the graft is trimmed back to the subchondral bone level using a bone reamer.

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X-ray image preoperatively

Deep osteochondritic defect. Free joint body lies in the mouse bed

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X-ray postoperatively in plaster

Sagittal Z-shaped shortening of the ulna and osteosynthesis with five bone screw grafts.

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MRI preoperative

Free joint body lies intercondylar. Clear joint effusion and deep and free mouse bed visible.

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Situs intraoperatively

Punched out defect. Mouse bed is freed from necrotic material, tapped and relined with autologous bone

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Situs intraoperatively

Free joint body is refixed with bone screws graft. Protruding head is shortened

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11 years postoperatively

The patient is symptom-free

Clinical case of Dr. Klaus Pastl, Linz in Austria. Refixation of a free joint body with a human bone screw graft. (documentation period 1996-2007) © surgebright GmbH

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