Osteochondritis Dissecans in Children

Green, William T.; Banks, Henry H.

doi:10.2106/00004623-195335010-00004

Cited by 183 publications

(78 citation statements)

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“…The English literature describes 24 cases in which osteochondritis dissecans patellae was the apparent diagnosis [1,[5][6][7][8][9][11][12][13][14][15][16][17]. The English literature describes 24 cases in which osteochondritis dissecans patellae was the apparent diagnosis [1,[5][6][7][8][9][11][12][13][14][15][16][17].…”

Section: Discussionmentioning

confidence: 99%

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The dorsal defect of the patella

1976

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The dorsal defect of the patella is described and 16 cases are presented. The typical dorsal patellar defect is a round, radiolucent lesion surrounded by a zone of sclerosis located on the superolateral aspect of the dorsal surface of the patella. The location, radiographic appearance and clinical course of the defect are unique, distinguishing it from other lesions of the patella. The authors suggest that the dorsal defect is an anomaly of Ossification and of little clinical significance.

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Section: Discussionmentioning

confidence: 99%

“…Spontaneous healing without treatment either conservative or surgical has been reported but usually requires a considerable period of time [6,20,21]. Spontaneous healing without treatment either conservative or surgical has been reported but usually requires a considerable period of time [6,20,21].…”

Section: Discussionmentioning

confidence: 99%

The dorsal defect of the patella

1976

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“…It may be familial (Smith, 1960). The majority of patients are males (Green and Banks, 1953). We have also cared for one patient presenting as a case of Still's disease with what appeared to be a typical Still's rash from the first day of life, in whom the bilateral knee pain and swelling was due to epiphysitis of the tibial epiphyses.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of "Probable" Still's Disease and its Outcome

Ansell¹,

Bywaters²

1962

Annals of the Rheumatic Diseases

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“…60 Skeletal immaturity, small lesion size, and lesion location on the medial femoral condyle have been associated with higher healing rates. 10, 14, 24, 27, 28, 39, 58, 60 Three to six months of non-operative management is advised by most authors, with treatment ranging from avoidance of sports to strict immobilization and non-weightbearing. 4, 10, 16, 27, 28, 55, 60 Drilling has been shown to result in union and good clinical results in 80-90 % of lesion which failed previous non-operative management.…”

Section: Introductionmentioning

confidence: 99%

Does Operative Fixation of an Osteochondritis Dissecans Loose Body Result in Healing and Long-Term Maintenance of Knee Function?

2009

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Background Osteochondritis dissecans (OCD) can progress to loose body formation resulting in a Grade IV defect. The decision to fix versus excise the loose body is controversial. Published operative fixation outcomes are small case series with short follow-up. Hypothesis Operative fixation (ORIF) of the loose body into the grade IV defect will heal and approximate “normal” knee function at long-term follow-up. Study Design Case series Methods Twelve patients were identified who underwent ORIF of a knee OCD loose body into the Grade IV osteochondral defects ranging in size from 2.0 to 8.0 cm2 (mean 3.5 cm2). After 12 weeks, hardware was removed and healing was assessed. Long-term outcomes were assessed with a Knee injury and Osteoarthritis Outcome Score (KOOS) and a Marx activity score. Results Arthroscopy for screw removal revealed stable healing in 92% (11/12) of patients. No patients required subsequent surgery for a loose body. At an average of 9.2 years follow-up (range 3.8-15.8 years) 83 % (10/12) of patients completed the KOOS. KOOS subscale scores for pain (mean 87.8, range 67-100), other symptoms (mean 81.8, range 61-96), function in activities of daily living (mean 93.1, range 72-100), and sports and recreation function (mean 74.0, range 40-100) were not significantly lower than published age matched controls. However the KOOS subscale for knee related quality of life (mean 61.9, range 31-88) was significantly lower (p = 0.003). Conclusions Operative fixation of Grade IV OCD loose bodies results in stable fixation. At an average 9 years after surgery, patients did not have symptoms of osteoarthritis pain and had normal function in activities of daily life. However, patients reported significantly lower knee related quality of life. Operative fixation of OCD loose bodies is a better alternative to lesion excision.

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Osteochondritis Dissecans in Children

Cited by 183 publications

References 0 publications

The dorsal defect of the patella

The dorsal defect of the patella

Diagnosis of "Probable" Still's Disease and its Outcome

Does Operative Fixation of an Osteochondritis Dissecans Loose Body Result in Healing and Long-Term Maintenance of Knee Function?

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