99m-Technetium phosphate compound joint scintigraphy in the management of juvenile osteochondritis dissecans of the femoral condyles

Cahill, Bernard R.; Berg, Ben C.

doi:10.1177/036354658301100509

Cited by 164 publications

(74 citation statements)

References 12 publications

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“…Cahill and Berg 9 areas of the knee in anteroposterior projection: areas 1 and 2 are in the medial condyle, area 3 is the central zone bordered by the intercondylar tibial eminences, and areas 4 and 5 are in the lateral condyle.…”

Section: Methodsmentioning

confidence: 99%

Femoral osteochondritis of the knee: Prognostic value of the mechanical axis

González-Herranz

Rodrı́guez

Fuente

2017

Journal of Children's Orthopaedics

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PurposeFemoral osteochondritis dissecans (OCD) is a disorder of unknown aetiology and variable prognosis that causes knee pain. In this paper, the authors study the impact of lower limb malalignment on the development and prognosis of OCD.MethodsAfter anteroposterior (AP) and lateral radiograph and MRI of the knee, 53 cases of OCD were diagnosed. All patients were studied by standing full-length AP radiograph of the lower extremities in order to analyse the relationship between the femorotibial and mechanical axis and the location and stability of the osteochondritis.ResultsThe OCD lesion was located in the medial condyle (zone 2) in 75.5% of cases (40 cases). The lateral condyle was affected in 24.5% of cases (zone 4 in nine cases and zone 5 in four cases). The femorotibial angle (anatomical axis) was normally aligned in 68% of cases. A valgus deformity was observed in 9.5% of cases and a varus deformity in 22.5%. The mechanical axis of the limb appeared normal in only 32% of cases, with medial deviation in 53%, and lateral deviation in 15% of cases. When the OCD lesion was located in the medial condyle (40 cases), the mechanical axis also crossed the knee through the medial zone in 28 cases. When the OCD lesion was located in the lateral condyle (13 cases), the mechanical axis crossed the knee through zones 1 or 2 in four cases. In stable OCD, the mechanical axis and location of the lesion coincided in 19 of 36 cases (52%), compared with 16 of 17 cases (94%) in unstable OCD.ConclusionsThere is a high correlation between OCD location and lower limb mechanical axis deviation. The convergence of the mechanical axis with the location of the OCD lesion may be considered an associated factor in fragment instability. This convergence is more common in unstable OCD.

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Section: Methodsmentioning

confidence: 99%

Femoral osteochondritis of the knee: Prognostic value of the mechanical axis

González-Herranz

Rodrı́guez

Fuente

2017

Journal of Children's Orthopaedics

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“…1 ). 23 The same images were used to grade the amount of graft osseous incorporation and recorded as a percentage of the original graft size. Grafts were considered fully integrated if there was no cystic change in the subchondral bone.…”

Section: Methodsmentioning

confidence: 99%

Osseous Integration after Fresh Osteochondral Allograft Transplantation to the Distal Femur

et al. 2011

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Objective:Fresh osteochondral allograft transplantation (OCA) is an increasingly available option for patients with damage to the bone-cartilage complex of the distal femur. This study prospectively assesses osseous integration and early clinical results following fresh OCA with single or multiple cylindrical grafts to the femoral condyle.Design:Patients with grade 4 International Cartilage Repair Society (ICRS) defects of the distal femur were treated with OCA. Outcome measures were collected preoperatively and postoperatively at 6, 12, and 24 months. Computed tomography (CT) scans obtained at 6 months were used to assess degree of osseous incorporation regionally.Results:Thirty-four patients, with a mean age of 34.5 years (range, 15-61), with a mean femoral osteochondral lesion of 5.7 cm2 (range, 1.5-15.0) due to focal osteoarthritis, osteochondritis dissecans, and avascular necrosis, are reported. Statistically significant (P < 0.05) mean improvement in outcome scores at 2 years included Knee Injury and Osteoarthritis Outcomes Score (KOOS) pain, sports and recreation, quality of life, and International Knee Documentation Committee (IKDC). CT imaging indicated grafts implanted to direct weightbearing regions had >75% incorporation (20/26 grafts) compared to <50% incorporation in the indirect weightbearing regions (8/14 grafts). A greater degree of incorporation and earlier outcome improvement were found after single (n = 23) compared to multiple (n = 11) grafts.Conclusion:CT scans were used to assess osseous incorporation of fresh osteochondral allografts in a cohort that showed significant improvements after 2 years. Single-graft implantation is associated with stable incorporation of a greater percentage of the graft. Lesser incorporation appears more frequently with grafts in posterior indirect weightbearing regions of the condyle and multiple contiguous grafts.

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“…All lesions were in the weight-bearing portion of the condyle as determined on the sagittal view. The sagittal view was divided into three separate segments according to the classification system of Cahill and Berg 31 : A (anterior), B (middle), and C (posterior). The size of the lesion (length, line with a straight edge.…”

Section: Data Collectionmentioning

confidence: 99%