Large osteochondral fragments can be reattached with cannulated headless screws.
As headless screws are not resorbable, it is important that the ends of the screws are below the cartilage. The bony part of the fragment must therefore be large enough to accommodate the proximal thread of the headless screw.
Note: The osteochondral fragment can become necrotic, leading to prominence of the screw end. This is suggested by pain during movement, and mandates screw removal.
At least two divergent screws should be used to provide satisfactory fixation and some axial compression.