Osteochondritis Dissecans:<i>A Histologic and Autoradiographic Study in Man</i>

Lindén, Bjarne; Telhag, H

doi:10.3109/17453677708994817

Cited by 58 publications

(50 citation statements)

References 9 publications

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“…Fairbank's [6] theory, later advocated by Smillie [24], was that repetitive microtrauma caused OCD of the knee. Trauma, either acute or repetitive microtrauma, has become a more accepted cause of OCD as a result of the high incidence of this disorder in the athletic population [2,4,6,7,10,13,14,16,28]. Despite the current consensus, the etiology of OCD remains unknown, and it may be multifactorial.…”

Section: Introductionmentioning

confidence: 99%

“…A majority of the studies analyzed specimens from medial femoral condyle lesions (Table 2). Four studies only reported the histology of the progeny fragments that were removed from the knee [4,8,9,16] and six studies reported histology of the progeny fragments and the associated parent bone with inconsistent methodology [3,10,14,20,28,31]. One study collected biopsy specimens from both the progeny fragment and parent bone but did not report these separately [30].…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

“…Of the 11 studies, four used formalin (varying concentrations) [10,14,28,31], one study each used formaldehyde 10% [4] or alcohol [20], and five did not report a fixation agent [3,8,9,16,30]. Decalcification agents used among the studies varied: one study used 5% nitric acid and 70% alcohol [4], one study used 40% formic acid and 20% sodium citrate [14], one study used EDTA [28], one study reported that no decalcification was used [20], and seven did not report on decalcification [3, 8-10, 16, 30, 31]. For histological analysis, six separate stains/analyses were used with varying frequency (Table 1).…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

“…For histological analysis, six separate stains/analyses were used with varying frequency (Table 1). Six studies used hematoxylin and eosin [4,14,16,28,30,31], two used Safranin-O (one in combination with Fast-Green) [14,31], one used toluidine blue [14], one used Alcian blue [10], one study used von Kossa stain [10], one study used Gomori trichrome stain [10], and one study used Goldner stain [14]. Two studies preoperatively labeled with tetracycline [14,20] and three studies did not use any staining techniques and only observed crosssections through photomicrographs [3,8,9].…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

“…Several reports have identified patients with OCD within families and among several generations, although many of these reports were in families with dwarfism or short stature [1,12,19,26,27]. Ischemia has also been proposed as a cause of OCD [3,5,14], although whether this is a primary cause, a secondary effect of trauma, or other pathophysiology is unclear. Fairbank's [6] theory, later advocated by Smillie [24], was that repetitive microtrauma caused OCD of the knee.…”

Section: Introductionmentioning

confidence: 99%

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Osteochondritis Dissecans Knee Histology Studies Have Variable Findings and Theories of Etiology

Shea

Jacobs

Carey

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Although many etiological theories have been proposed for osteochondritis dissecans (OCD), its etiology remains unclear. Histological analysis of the articular cartilage and subchondral bone tissues of OCD lesions can provide useful information about the cellular changes and progression of OCD. Previous research is predominantly comprised of retrospective clinical studies from which limited conclusions can be drawn. Questions/purposes The purposes of this study were threefold: (1) Is osteonecrosis a consistent finding in OCD biopsy specimens? (2) Is normal articular cartilage a consistent finding in OCD biopsy specimens? (3) Do histological studies propose an etiology for OCD based on the tissue findings? Methods We searched the PubMed, Embase, and CI-NAHL databases for studies that conducted histological analyses of OCD lesions of the knee and identified 1560 articles. Of these, 11 met our inclusion criteria: a study of OCD lesions about the knee, published in the English language, and performed a histological analysis of subchondral bone and articular cartilage. These 11 studies were assessed for an etiology proposed in the study based on the study findings. Results Seven of 11 studies reported subchondral bone necrosis. Four studies reported normal articular cartilage, two studies reported degenerated or irregular articular cartilage, and five studies found a combination of normal and degenerated or irregular articular cartilage. Five studies proposed trauma or repetitive stress and two studies proposed poor blood supply as possible etiologies. Conclusions We found limited research on histological analysis of OCD lesions of the knee. Future studies with consistent methodology are necessary to draw major conclusions about the histology and progression of OCD lesions. Inconsistent histologic findings have resulted in a lack of consensus regarding the presence of osteonecrosis, whether the necrosis is primary or secondary, the association of cartilage degeneration, and the etiology of OCD. Such studies could use a standardized grading system to allow better comparison of findings.

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