Resident Physician HonorHealth Scottsdale, Arizona, United States
Objectives: The purpose of this review is to provide a thorough understanding of OLTs, with a specific focus on the juvenile population. We evaluate the recent literature regarding the outcomes of various surgical treatment; modalities in the pediatric patient.
Design: Systematic review
Results: Surgical options for OLTs include debridement of the necrotic subchondral bone, removal or internal fixation of the fragment, and bone marrow stimulation. While the outcomes after surgical treatment of pediatric OLTs are generally favorable, the paucity of investigation in this demographic is alarming. Further research is needed to better inform practitioners and families regarding these outcomes, as treatment plans are highly dependent on the individual patient in question.
Conclusions: The literature published since 2015 on OLTs in juvenile patients has demonstrated a favoring of more aggressive treatment for OLT in these cohorts, with generally favorable results in patients treated with surgery. However, given the ongoing paucity of the literature specifically evaluating the unique behavior of juvenile OLTs and the proposed therapeutic options, we urge additional high-quality studies that involve larger patient populations to provide prognostic details and guidance for the conservative or surgical management of juvenile OLT.
