Modern aspects of the treatment of Koenig’s disease in children

Abstract

Relevance. Koenigs disease, or osteochondritis dissecans of the knee joint, has been known since the end of the 16th century. The incidence is high (18-30 cases per 100 thousand of the population), while there is no common opinion on the management tactics and the treatment method for this pathology. Incorrect treatment choice as well as the lack of active management tactics provokes inevitably the transformation of primary pathology in early deforming arthrosis, followed by a pronounced decrease in joint function and the working capacity of an adult patient. Material and methods: electronic scientific library PubMed, SciVerse (Science Direct), and Scopus were the open Internet tools we searched for literature sources. For data search we used following keywords: dissecting osteochondritis, Koenigs disease, osteochondritis dissecans. The article presents the main results in the publications of domestic and foreign experts with an emphasis on the diagnosis and treatment of dissecting osteochondritis. In some cases, their own comments about the diagnosis and treatment are made. Conclusion. In our opinion, the surgical objectives are to restore the congruency of the articular surfaces by improving vascularization of the affected area, tight fixation of the unstable fragment and protecting the supporting part of the loaded condyle section in the postoperative period. Due to the rarity of such a pathology and the lack of research with a high level of evidence base, further development of treatment methods is actual.