DOI: 10.1002/arj.70632 ISSN: 0749-8063

Editorial Commentary : Beyond the Lesion: Individualizing Safe Implant Depth During Osteochondritis Dissecans Fixation in Skeletally Immature Knees

Peter D. Fabricant

Abstract

Successful fixation of unstable osteochondritis dissecans in skeletally immature patients requires precise implant placement as well as careful appreciation of the distal femoral physis beyond the lesion. Although 16‐mm drill or screw length can reliably provide a 3 mm or greater margin of safety between the implant and distal femoral physis, isotropic 3‐dimensional magnetic resonance imaging sequences allow surgeons to incorporate multiplanar reformatted imaging into preoperative planning to measure patient‐ and lesion‐specific safe implant depths and optimize implant trajectories. Individualized magnetic resonance imaging‐based planning has the potential to maximize fixation while minimizing the risk of physeal injury.