Electromagnetic navigation reduces radiation exposure for retrograde drilling in osteochondrosis dissecans of the talus

Abstract Background Retrograde drilling in osteochondrosis dissecans (OCD) is a widely used surgical intervention. A radiation-free electromagnetic navigation system (ENS)-based method was compared with the standard freehand fluoroscopic (SFF) regarding clinical applicability. Methods We performed cohort study at department of Orthopaedics Level 1 children’s hospital 40 patients (20 SFF and 20 ENS). talar dome unstable medial OCD (MRI stage 2 according to Hepple’s revised classification; International Cartilage Repair Society). The outcome measurements were: (a) Intraoperative fluoroscopy exposure length surgery (b) Postoperative serial follow-up MRIs every 6 months. Results 22 female 18 male aged 13.8 ± 1.6 years (range: 11–17 years) were included. Using ENS technique, significantly reduced 20.2 6.4 min 36.1 11.8 (p < 0.01) for technique. average x-ray radiation time technique 23.5 13.5 sec 1.9 1.7 ( p 0.01). Radiation from 44.6 19.7 mSv (SFF technique) 5.6 2.8 (ENS perforation cartilage occurred once group. Correct placement channel verified all on MRI after six months timely healing seen two years. Conclusions provides significant reduction exposure. without intraoperative perforation. radiological parameters are comparable SFF- ENS-guided retrograde drilling. Trial registration WF – 085/20, 05/2020 “retrospectively registered” https://www.aerztekammer-hamburg.org/ethik_kommission.html .