Papers - MORITA Yudai
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Yokoe T., Yang F., Tajima T., Yamaguchi N., Morita Y., Chosa E.
Foot and Ankle Surgery 31 ( 1 ) 20 - 24 2025.1
Authorship：Lead author, Last author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Foot and Ankle Surgery
Background: This study aimed to investigate ankle syndesmosis in healthy subjects under non-weight bearing (NWB) and weight bearing (WB) conditions using two US methods. Methods: The anterior tibiofibular clear space (ATFCS) was measured in healthy subjects in NWB and WB conditions using two US procedures. Method 1 measured 10 mm above the ankle joint and Method 2 measured 30° from the line of 10 mm above the ankle joint. Results: A total of 60 ankles from 30 subjects (male/female, 15/15) were included. There was a significant difference in the ATFCS between the two US methods (p < 0.001), and Method 2 was better at detecting the change in diastasis from NWB to WB conditions. The ATFCS was significantly greater on WB than on NWB, irrespective of the US method. Conclusions: Method 2 was better at detecting diastasis of the syndesmosis from NWB to WB conditions. The influence of WB needs to be considered when evaluating syndesmosis using US. Level of evidence: Cross-sectional cohort study; Level of evidence, Ⅳ
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Morita Y., Tajima T., Yamaguchi N., Yokoe T., Nagasawa M., Ota T., Ouchi K., Chosa E.
Scientific Reports 14 ( 1 ) 6192 2024.12
Authorship：Lead author, Last author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Scientific Reports
Posterior tibial translation (PTT) after double-bundle posterior cruciate ligament (PCL) reconstruction has sometimes occurred. Purpose of this study is to identify the risk factors for postoperative PTT after double-bundle PCL reconstruction with a hamstring autograft. Comparing the results of bilateral gravity sag view (GSV) at 12 months after surgery, over 5-mm PTT was defined as ‘failure’ in this study. Of 26 isolated PCL reconstruction cases, over 5-mm PTT was seen in 7 cases (group F: 9.57 ± 1.28 mm), and 19 cases had less than 5 mm (group G: 2.84 ± 1.29 mm). Age, sex, body mass index (BMI), preoperative GSV, posterior slope angle of the tibia, anterolateral bundle (ALB) and posteromedial bundle (PMB) graft diameters, and tibial tunnel diameter were evaluated. The two groups were compared with the 2 × 2 chi-squared test, the Mann Whitney U-test, and Spearman’s rank correlation coefficient. Multivariate logistic regression analysis was also performed to determine the risk factor. Statistical significance was indicated as p < 0.01 for correlation with postoperative PTT, and as p < 0.05 for all other comparisons. Mean age (group G 31.8 ± 12.5 vs group F 34.9 ± 15.9 years), sex (male/female: 15/4 vs 3/4), BMI (25.6 ± 4.6 vs 24.9 ± 3.9 kg/m<sup>2</sup>), preoperative GSV (11.3 ± 2.2 vs 11.6 ± 2.9 mm), PMB diameter (5.37 ± 0.33 vs 5.36 ± 0.48 mm), and tibial tunnel diameter (9.32 ± 0.58 vs 9.29 ± 0.49 mm) showed no significant differences. ALB diameter was significantly greater in group G (7.0 ± 0.5 mm) than in group F (6.5 ± 0.29 mm; p = 0.022). There was also a significant difference in posterior tibial slope angle (group G 9.19 ± 1.94 vs group F 6.54 ± 1.45, p = 0.004). On Spearman rank correlation coefficient analysis, ALB diameter GSV (correlation coefficient: − 0.561, p = 0.003) and posterior tibial slope angle (correlation coefficient: − 0.533, p = 0.005) showed a significant correlation with postoperative PTT. Multivariate logistic regression analysis showed that ALB diameter (OR 19.028; 95% CI 1.082–334.6; p = 0.044) and posterior slope angle of tibia (OR 3.081; 95% CI 1.109–8.556; p = 0.031) were independently associated with postoperative PTT, respectively. In double-bundle PCL reconstruction with hamstring, smaller ALB graft diameter and lower (flatted) tibial slope angle were considered risk factors for postoperative PTT.
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Direct repair of the chronic ochronotic Achilles tendon rupture: a case report Reviewed
Yokoe T., Nagasawa M., Tajima T., Yamaguchi N., Ota T., Morita Y., Chosa E.
BMC Musculoskeletal Disorders 25 ( 1 ) 843 2024.12
Authorship：Lead author, Last author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：BMC Musculoskeletal Disorders
Background: Alkaptonuria (AKU) is a rare hereditary disease. Ochronotic arthropathy, tendinopathy, and osteopenia/osteoporosis are generally musculoskeletal manifestations in patients with AKU. Because of the ochronotic tendinopathy and osteopenia, the surgical strategy for chronic ochronotic Achilles tendon rupture may be challenging. No studies have reported the surgical treatment of chronic Achilles tendon rupture in patients with AKU. Case presentation: We report a case of AKU that required surgical treatment for chronic Achilles tendon rupture. A 60-year-old woman was referred to our department for the assessment of left hindfoot pain that persisted for more than nine months after an ankle sprain. Three years prior to the first presentation to our hospital, she was diagnosed with AKU due to pigmented hip cartilage at the time of total hip arthroplasty. The patient was diagnosed as chronic Achilles tendon rupture based on the results of physical examination and magnetic resonance imaging (MRI). The MRI showed enlarged scar tissue of the Achilles tendon with an intrasubstance high signal intensity. We performed resection of the central part of the scar tissue (total length, 24 mm) followed by direct repair using the proximal and distal stumps of the scar tissue. The MRI at 12months after surgery showed continuity of the repaired Achilles tendon. At 18 months after surgery, the Achilles Tendon Total Rupture Score improved from 22 points preoperatively to 84 points postoperatively. The foot and ankle outcome score also improved. Conclusions: We reported a case of AKU with chronic Achilles tendon rupture in which direct repair using scar tissue between the tendon stumps was effective. Careful selection of the surgical procedure for the treatment of chronic ochronotic Achilles tendon rupture is recommended because of concomitant ochronotic tendinopathy and osteopenia/osteoporosis.
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リファンピシン使用によりステロイド作用が減弱し治療に難渋した手関節非結核性抗酸菌症の1例 Reviewed
松永 美穂, 大田 智美, 田島 卓也, 山口 奈美, 長澤 誠, 森田 雄大, 横江 琢示, 帖佐 悦男
整形外科と災害外科 73 ( 3 ) 602 - 605 2024.9
Authorship：Lead author, Last author, Corresponding author Language：Japanese Publishing type：Research paper (scientific journal) Publisher：西日本整形・災害外科学会
【はじめに】ステロイド薬は他薬との薬物相互作用が比較的少なく汎用されるが，抗結核薬のリファンピシン（以下RFP）との相互作用はあまり知られていない．ネフローゼ症候群加療中に非結核性抗酸菌症（以下NTM）を合併し，ステロイドとRFPの併用で原疾患およびNTMの治療に難渋した1例を経験した．【症例】41歳男性，21歳時にネフローゼ症候群と診断され，ステロイドを内服中に手関節掌背側の腫脹を認め，滑膜切除術後に非結核性抗酸菌性滑膜炎の診断となった．RFPを含む抗結核薬3剤を開始したところ，ネフローゼ症候群が悪化しステロイドを増量，尿蛋白は改善するも手関節腫脹が再発し，2回目の滑膜切除術施行後，高気圧酸素療法で感染は鎮静化した．【考察】NTMにはRFPが汎用されるが，ステロイドとの相互作用により治療に難渋することがある．薬物の相互作用を十分に熟知し，NTMの治療にあたる必要がある．
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Differences in Retromalleolar Fibular Groove Morphology According to Level of Axial Computed Tomography Scans Reviewed
Takuji Yokoe, Takuya Tajima, Koki Ouchi, Nami Yamaguchi, Yudai Morita, and Etsuo Chosa
The Orthopaedic Journal of Sports Medicine 12 ( 3 ) 2024.3
Language：English Publishing type：Research paper (scientific journal)
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Screening of Undiagnosed Increased Lateral Ankle Laxity Using Stress Ultrasonography Reviewed
Yokoe T., Tajima T., Chosa E., Yamaguchi N., Morita Y.
Orthopaedic Journal of Sports Medicine 12 ( 4 ) 23259671241235162 2024.3
Authorship：Lead author, Last author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Orthopaedic Journal of Sports Medicine
Background: Some patients with lateral ankle sprain (LAS) will experience chronic lateral ankle instability (CLAI). However, not all of those with residual increased lateral ankle laxity (ILAL) become symptomatic. There is a lack of evidence regarding the prevalence of undiagnosed ILAL in the general population. Purpose: To evaluate the prevalence of undiagnosed ILAL with the use of stress ultrasonography (US) and to investigate the percentage of ankle sprain copers (ASCs) with ILAL. Study Design: Cross-sectional study; Level of evidence, 3. Methods: The anterior talofibular ligament (ATFL) lengths in college students without diagnosis of CLAI were measured consecutively in stress and nonstress positions. The ATFL ratio was calculated as an indicator of lateral ankle laxity according to a previously reported method. The manual anterior drawer test was also performed. The Cumberland Ankle Instability Tool (CAIT) and Ankle Instability Instrument (AII) were used to assess subjective impairments related to CLAI. The correlation between the ATFL ratio and CAIT score was evaluated. Results: A total of 207 ankles from 106 participants (mean age, 23.9 ± 2.2 years; male/female, 64/42) were included. Overall, 38 participants (35.8%; 50 ankles [24.2%]) were classified as having undiagnosed ILAL. Of the ankles with no history of LAS, 8% showed ILAL. Overall, 53 participants (50%) had a history of LAS and were all classified as ASCs. Of the 82 ankles from these ASCs, 40 (48.8%) were regarded as having undiagnosed ILAL. There was no correlation between the ATFL ratio and CAIT scores (r = -0.09, P =.414). Conclusion: The prevalence of undiagnosed ILAL by stress US screening was approximately one-third in young adults. In this study, 48.8% of the ankles from ASCs showed ILAL.
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Yokoe T., Tajima T., Yamaguchi N., Morita Y., Chosa E.
Journal of Orthopaedic Science 28 ( 6 ) 1543 - 1547 2023.11
Authorship：Lead author, Last author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Orthopaedic Science
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Remnant-Preserved Single-Bundle Anterior Cruciate Ligament Augmentation in Multi-ligamentous Knee Reconstruction. Reviewed
Tajima T, Yamaguchi N, Morita Y, Yokoe T, Nagasawa M, Ota T, Kawagoe S, Nakamura Y, Chosa E.
J Knee Surg 36 ( 10 ) 1095 - 1101 2023.10
Language：English Publishing type：Research paper (scientific journal)
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第2趾DIP関節脱臼に対する観血的整復術後の早期スポーツ復帰の一例
川越 亮, 田島 卓也, 山口 奈美, 大田 智美, 長澤 誠, 森田 雄大, 横江 琢示, 帖佐 悦男
整形外科と災害外科 72 ( 3 ) 485 - 487 2023.9
Authorship：Lead author, Last author, Corresponding author Language：Japanese Publishing type：Research paper (scientific journal) Publisher：西日本整形・災害外科学会
【はじめに】観血的整復術を必要とした第2趾のDIP関節脱臼の1例を経験した．【症例】16歳男性．空手中に受傷．第2趾DIP関節脱臼で徒手整復を行ったが整復不能であったため，観血的整復術を行った．整復阻害因子は長趾屈筋腱であり，蹠側板の嵌頓は認めなかった．術後早期の競技復帰希望があったため母趾とのbuddy tapingを指示し復帰とした．術後6か月が経過し特に問題なく競技継続している．【考察】DIP関節脱臼の整復阻害因子は蹠側板や長趾屈筋腱の報告があり，本症例では長趾屈筋腱であった．また，術後のスポーツ復帰について，競技によっては症状次第で早期復帰が見込めると考えられた．
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Risk factors associated with throwing injuries in young baseball players
Nagasawa Makoto, Tajima Takuya, Kawagoe Shuichi, Yamaguchi Nami, Morita Yudai, Yokoe Takuji, Ohta Tomomi, Izumi Toshihiko, Ishida Yasuyuki, Chosa Etsuo
Journal of Shoulder and Elbow Surgery 32 ( 8 ) 1673 - 1680 2023.8
Authorship：Lead author, Last author, Corresponding author Language：English Publishing type：Research paper (scientific journal)
Background
Few studies have retrospectively analyzed the relationship between joint range of motion (ROM) and muscle flexibility and shoulder and elbow throwing injuries in a large number of elementary school baseball players. The purpose of this study was to retrospectively identify the physical factors related to shoulder and elbow throwing injuries in younger baseball players.
Methods
A total of 2466 younger baseball players belonging to our Prefecture Rubber Baseball Federation who participated in medical check-ups from 2016 to 2019 were analyzed. Players completed a questionnaire and had a medical check-up that included a physical examination and ultrasonography. ROM (internal rotation [IR] angle and external rotation angle) of the shoulder and hip and the finger-to-floor distance and heel-to-buttock distance were measured. The straight leg raise was also performed. The results of two groups (normal group and injury group) were compared using the χ2 test, Mann-Whitney U test, and Student t test. Stepwise forward logistic regression models were developed to identify risk factors.
Results
On univariate analysis, nine of the 13 evaluated items showed significant decreases in ROM and muscle flexibility in the injury group. On multiple logistic regression analysis, grade, finger-to-floor distance, IR angle of the dominant side shoulder, and IR angle of the nondominant side hip were significantly associated with the occurrence of throwing injuries. Decreased total shoulder angle was observed not only on the dominant side but also on the nondominant side in the injury group.
Conclusion
Decreased ROM and muscle flexibility were risk factors for baseball-related throwing injuries in elementary school baseball players. To prevent shoulder and elbow throwing injuries, players, coaches, medical staff, and parents need to be aware of these findings. -
Ureter position and risk of ureteral injury during lateral lumbar interbody fusion Reviewed
Makoto Nagasawa,MD,Takuya Tajima,MD,PhD,Shuichi Kawagoe, MD,Nami Yamaguchi,MD,PhD, Yudai Morita,MD,Takuji Yokoe, MD,Tomomi Ota,MD,Toshihiko Izumi, MD, PhD,Yasuyuki Ishida, MD,Etsuo Chosa,MD,PhD
Journal of Clinical Medicine 32 ( 8 ) 1673 - 1680 2023.5
Language：English Publishing type：Research paper (bulletin of university, research institution) Publisher：Elsevier
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Yokoe T., Tajima T., Yamaguchi N., Morita Y., Chosa E.
Knee Surgery Sports Traumatology Arthroscopy 31 ( 5 ) 1994 - 2000 2023.5
Authorship：Lead author, Last author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Knee Surgery Sports Traumatology Arthroscopy
Purpose: This study aimed to evaluate the relationship between generalized joint laxity (GJL) and stress ultrasonographic (US) findings of the anterior talofibular ligament (ATFL) of healthy young men. Methods: The ATFL lengths of healthy young men were consecutively measured in the stress and nonstress positions. The ATFL ratio was calculated as an indicator of lateral ankle laxity. GJL was evaluated using the Beighton score (BS), and a BS of ≥ 5 was considered GJL. The manual anterior drawer test (ADT) was also performed. The results of stress US and ADT were compared between subjects with and without GJL, and the correlation between GJL and US findings was examined. Results: A total of 13 subjects with GJL and 95 without GJL were included in the study. The mean BSs in the GJL and no-GJL groups were 5.9 ± 0.9 and 1.1 ± 1.3, respectively (p < 0.0001). The GJL group showed a higher grade of ADT than the no-GJL group (p < 0.0001). Significant differences were found in the stress ATFL length (23.6 ± 1.8 mm vs. 21.7 ± 1.8 mm, p = 0.002) and ATFL ratio (1.15 ± 0.06 vs. 1.07 ± 0.03, p < 0.0001) between the GJL and no-GJL groups. Spearman’s correlation coefficients showed a moderate correlation between the BS and ATFL ratio (r = 0.45, p < 0.0001). Conclusion: The present study showed significant differences in the ATFL ratio and stress ATFL length between young men with and without GJL. The BS was moderately correlated with the lateral ankle laxity in this population. Level of evidence: Level IV.
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Risk factors of failure results after double-bundle reconstruction with autogenous hamstring grafts for isolated posterior cruciate ligament rupture cases Reviewed
Yudai Morita,Takuya Tajima,Nami Yamaguchi,Takuji Yokoe,Makoto Nagasawa,Tomomi Ota,Kouki Ouchi,Etsuo Chosa
Scientific reports 6192 2023.3
Language：English Publishing type：Research paper (bulletin of university, research institution) Publisher：nature portfolio
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Risk factors of failure results after double-bundle reconstruction with autogenous hamstring grafts for isolated posterior cruciate ligament rupture cases Reviewed
Yudai Morita,Takuya Tajima,Nami Yamaguchi,Takuji Yokoe,Makoto Nagasawa,Tomomi Ota,Kouki Ouchi,Etsuo Chosa
Scientific reports 6192 2023.3
Language：English Publishing type：Research paper (bulletin of university, research institution)
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Yokoe T., Tajima T., Yamaguchi N., Morita Y., Chosa E.
Medicina Lithuania 59 ( 3 ) 2023.3
Authorship：Lead author, Last author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Medicina Lithuania
Muscle herniation of the lower extremity, such as tibialis anterior muscle herniation (TAMH), is not a rare cause of leg pain in athletes. However, a few studies have reported surgical treatment for TAMH, and the optimal surgical procedure remains controversial. Fasciotomy was reported to be effective for patients with TAMH. However, this procedure would be associated with a risk of intraoperative injury to the superficial peroneal nerve (SPN), although no previous literature has reported this complication. This case report aimed to report a case of bilateral TAMHs in which a traumatic neuroma of the SPN developed after fasciotomy. A 16-year-old baseball player presented with painful swelling lesions of the bilateral lower extremities (1 lesion on the right, 3 lesions on the left) after sports activities. An ultrasonographic evaluation showed swelling lesions of the anterolateral parts of the bilateral lower extremities in the standing position after dashing, while these lesions were not detected in the supine position. A fasciotomy of the crural fascia was performed after conservative treatment failed. Several days after surgery, the patient presented with weakened touch sensation over the dorsal area of the left foot. At the three-month follow-up examination, a swelling lesion with hard elasticity was identified. The palpation of this lesion caused a radiating sensation in the area supplied by the SPN. He was able to return to playing baseball six months after surgery. The patient was asymptomatic without palpation of the traumatic neuroma of the SPN at the latest follow-up examination. In conclusion, the present case report suggests that orthopedic surgeons need to consider the risk of iatrogenic injury to the SPN during fasciotomy for the treatment of TAMHs. However, there may be a risk of injuring the SPN because of the many variants of the course of the SPN within the compartment of the lower extremities.
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A Traumatic Neuroma Formation Following Fasciotomy for the Treatment of Tibialis Anterior Muscle Herniation:A Case Report Reviewed
Takuji Yokoe,Takuya Tajima,Nami Yamaguchi,Yudai Morita and Etsuo Chosa
medicina 2023.2
Language：English Publishing type：Research paper (scientific journal) Publisher：MDPI
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Risk Factors of Loss of Knee Range of Motion after Primary Anterior Cruciate Ligament Reconstruction following Preoperative Recovery of Knee Range of Motion Reviewed
Takuji Yokoe, Takuya Tajima, Nami Yamaguchi, Yudai Morita, Etsuo Chosa
The Journal of Knee Surgery 2022.12
Language：English Publishing type：Research paper (scientific journal) Publisher：Thieme
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Yokoe T., Tajima T., Kawagoe S., Yamaguchi N., Morita Y., Chosa E.
BMC Musculoskeletal Disorders 23 ( 1 ) 887 2022.12
Authorship：Lead author, Last author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：BMC Musculoskeletal Disorders
Background: A number of studies have evaluated risk factors for lateral ankle sprain (LAS) or chronic lateral ankle instability (CLAI). However, the definitive risk factors for LAS or CLAI remain controversial. The purpose of this study was to evaluate whether the contralateral healthy ankles of subjects with ipsilateral mechanical lateral ankle laxity (group I) show greater lateral ankle laxity in comparison to the healthy ankles of bilateral healthy controls (group B). Methods: From March 2020, anterior talofibular ligament (ATFL) lengths of young adult volunteers were cross-sectionally measured in non-stress and stress positions using a previously reported stress ultrasonography (US) procedure. The ATFL ratio (the ratio of stress ATFL/non-stress ATFL length) was calculated as an indicator of lateral ankle laxity. The manual anterior drawer test (ADT) was also performed. The US findings of healthy ankles from groups I and B were compared. Results: A total of 154 subjects in group B (mean age, 24.5 ± 2.8 years; male/female, 84/70) and 40 subjects in group I (mean age, 24.4 ± 2.3 years; male/female, 26/14) were included in the study. There was no significant difference in the ADT between the groups. There were no significant differences in the non-stress ATFL length (19.4 ± 1.8 vs. 19.3 ± 1.9, p = 0.84), stress ATFL length (20.8 ± 1.8 vs. 20.9 ± 1.9, p = 0.66), length change (1.5 ± 0.6 vs. 1.6 ± 0.6, p = 0.12) and ATFL ratio (1.08 ± 0.03 vs. 1.08 ± 0.03, p = 0.13) between the groups. Conclusion: No significant difference was detected between the contralateral healthy ankles of subjects with ipsilateral mechanical lateral ankle laxity and those of bilateral healthy controls.
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The Results of Orthopaedic Medical Examinations in Adolescent Amateur Weightlifters Reviewed
Yokoe T., Tajima T., Yamaguchi N., Nagasawa M., Morita Y., Chosa E.
International Journal of Environmental Research and Public Health 19 ( 21 ) 2022.11
Authorship：Lead author, Last author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：International Journal of Environmental Research and Public Health
Few studies have reported injuries and physical characteristics in adolescent weightlifters. The purpose of this study was to report the results of orthopaedic medical examinations in adolescent amateur weightlifters that were performed cross-sectionally from 2012 to 2019. The orthopaedic medical examination included physical examinations, generalized joint laxity, muscle and joint tightness, static alignment, muscle volume of the lower extremities, and medial longitudinal arch of the foot (the height from the tip of the navicular tubercle to the ground surface). A questionnaire survey regarding pain in the spine and lower extremities was also performed. A total of 99 adolescent weightlifters were included (male/female, 71/28; mean age, 16.2 ± 0.2 years). A total of 9.1% had received orthopaedic treatments, with spine injuries being the most prevalent. Of those who had not received orthopaedic treatments, 31.1% had pain in the spine or lower extremities (for >4 weeks). There were no significant gender differences in the incidence of pain or positive findings of physical examinations. Female weightlifters had a more reduced dorsiflexion of the ankle joint than male weightlifters (p = 0.02). Male weightlifters had a lower flexibility of the quadriceps than female weightlifters. The results of orthopaedic medical examinations in this study may help clinicians and young weightlifters to prevent injuries in competitive weightlifting.
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Yokoe T., Tajima T., Yamaguchi N., Morita Y., Chosa E.
Medicina Lithuania 58 ( 11 ) 2022.11
Authorship：Lead author, Last author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Medicina Lithuania
Osteochondral lesion (OCL) of the patellofemoral (PF) joint is not an uncommon cause of knee pain, and surgery is needed when conservative treatment fails. However, there is a lack of evidence regarding the optimal surgical treatment for OCL of the PF joint. Fixation of OCLs using autogenous osteochondral grafts has been reported to be effective for OCL of the knee. However, in this surgical technique, the biomechanical strength of osteochondral grafts may not be sufficient in patients with open physes due to the specific quality of the cartilage and subchondral bone given their age. There is a lack of studies reporting fixation of the OCL located in the PF joint using autogenous osteochondral grafts. We herein report a case of OCL of the femoral intercondylar groove where autogenous osteochondral grafts augmented with bioabsorbable pins were used to fix the lesion in a 14-year-old patient with open physes. Preoperative MRI revealed a completely detached OCL of the intercondylar groove (36 mm × 20 mm). Although a total of four osteochondral grafts were harvested from the non-weightbearing area of the lateral femoral condyle, cartilage detached from one of the grafts. The quality of the osteochondral grafts was considered to be insufficient for stabilization of the OCL; thus, two bioabsorbable pins were additionally inserted following fixation of the lesion using three osteochondral grafts. After two years of follow-up, postoperative functional scores were favorable without knee pain. The present case suggests that fixation of the OCL using autogenous osteochondral grafts may not be appropriate for young patients with open physes.