Osteochondritis Dissecans of the Femoral Condyle in the Growth Stage

Yoshida, Shigehito; Ikata, Takaaki; Takai, Hiroaki; Kashiwaguchi, Shinji; Katoh, Shinsuke; Takeda, Yoshitsugu

doi:10.1097/00003086-199801000-00023

Cited by 79 publications

(79 citation statements)

References 22 publications

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“…Several studies have noted associations between lateral femoral condyle OCD and discoid meniscus [56,74,85] and mechanical axis malalignment and the presence of OCD [33]. In fact, the positive association was present for varus malalignment and medial lesions as well as valgus malalignment for lateral lesions [33].…”

Section: Etiologymentioning

confidence: 98%

“…However, the work of De Smet and his colleagues did not differentiate young and old patients. When Yoshida et al [85] evaluated skeletally immature patients with this high T2 signal line separating the lesion, they could not predict stability accurately because the majority healed. Another study [63] suggested that if the criteria for instability included both the high T2 signal separating the lesion and a breach of the articular cartilage on T1-weighted images, then the accuracy in predicting instability shifted from 45% to 85%.…”

Section: Imagingmentioning

confidence: 99%

“…Success is sometimes reported when the clinical symptoms have resolved, but no study to date has defined an outcome measure for OCD lesions. Bearing this in mind, the rates of healing for nonoperative treatment have varied from 50% to 94% [8,9,11,13,26,28,31,32,35,48,49,70,85].…”

Section: Treatmentmentioning

confidence: 99%

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A Review of Knowledge in Osteochondritis Dissecans: 123 Years of Minimal Evolution from König to the ROCK Study Group

Edmonds

Polousky

2013

Clinical Orthopaedics &Amp; Related Research

215

223

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Background Osteochondritis dissecans (OCD) was first described to provide an explanation for the nontraumatic development of loose bodies within a joint. Despite many reports on the subject, there remains no clear understanding of the etiology, natural history, or treatment. Questions/purposes This review was undertaken to delineate (1) the etiology of OCD; (2) the presentation and locations; (3) the most appropriate imaging modalities; and (4) the most effective treatment strategies. Methods We reviewed the English literature using a database compiled from a Medline search for ''osteochondritis dissecans''. We identified 1716 publications, 1246 of which were in English. After exclusions, we reviewed 748 articles and of these cited 85. The observations of each study were then synthesized into this report. Results There appears to be no consensus concerning the etiology of OCD lesions. The presentations and locations are variable, but the knee, ankle, and elbow are most commonly involved. Although plain film assessment is important in OCD, there appears to be a trend toward the use of MRI, but the preferred sequences are in evolution. We found no consensus on the treatment of these lesions, related in part to the lack of agreement of methods for assessing outcomes. Conclusions Despite more than a century of study, we have made little advancement in our understanding of OCD. A study group has been formed to address this issue and actively seeks to answer these unknown issues regarding OCD.

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Section: Etiologymentioning

confidence: 98%

Section: Imagingmentioning

confidence: 99%

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A Review of Knowledge in Osteochondritis Dissecans: 123 Years of Minimal Evolution from König to the ROCK Study Group

Edmonds

Polousky

2013

Clinical Orthopaedics &Amp; Related Research

215

223

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“…When patients are properly selected, results of non-operative treatment for JOCD of the knee are very successful. In fact, a course of conservative therapy is proposed for skeletally immature patients with stable (grade 1 or 2) OCD lesions [7,[24][25][26]. However, even among these patients, if there are continued symptoms or healing failure confirmed by radiograph or [18].…”

Section: Discussionmentioning

confidence: 99%

“…The difference between JOCD and adult OCD depends on skeletal maturity determined by whether the physis is closed. This categorisation is useful because JOCD has shown more spontaneous healing with conservative treatment than adult OCD [3][4][5][6][7]. In addition, the stability of the OCD is important, because stable fragments more frequently respond to conservative therapy [8,9].…”

Section: Introductionmentioning

confidence: 99%

Osteochondral autograft transplantation for juvenile osteochondritis dissecans of the knee: a series of twelve cases

Sasaki

Matsumoto

Matsushita

et al. 2012

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to evaluate the clinical outcomes of osteochondral autograft transplantation (OAT) for juvenile osteochondritis dissecans (JOCD) lesions of the knee, especially time to return to sports. Methods Twelve knee JOCD lesions with OCD grade 3 and 4 categorised by magnetic resonance imaging (MRI) were treated with OAT. Nine male and two female skeletally immature patients averaging 13.7 years old were included. The OCD lesions were assessed arthroscopically and then fixed in situ using multiple osteochondral plugs harvested under fluoroscopy from the distal femoral condyle without damaging the physis. International Cartilage Repair Society (ICRS) score and Lysholm score were assessed pre-and postoperatively.Results After a mean follow-up of 26.2±15.1 months, the International Knee Documentation Committee (IKDC) subjective score significantly improved (p<0.01). According to the IKDC score, objective assessment showed that ten of 12 (83 %) had excellent results (score: A) after OAT and significantly improved (p<0.01). Based on ICRS criteria, results were satisfactory in all patients. No patients experienced complications at the graft harvest site. All patients returned to their previous level of athletic activity at an average of 5.7 months after the surgery. Conclusions OAT for JOCD of the knee provided satisfactory results in all patients at a mean follow-up of 26.2 months.

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Osteochondritis Dissecans: Current Treatment Options

Micheli¹,

McCartyIII²

2004

Articular Cartilage Lesions

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Osteochondritis Dissecans of the Femoral Condyle in the Growth Stage

Cited by 79 publications

References 22 publications

A Review of Knowledge in Osteochondritis Dissecans: 123 Years of Minimal Evolution from König to the ROCK Study Group

A Review of Knowledge in Osteochondritis Dissecans: 123 Years of Minimal Evolution from König to the ROCK Study Group

Osteochondral autograft transplantation for juvenile osteochondritis dissecans of the knee: a series of twelve cases

Osteochondritis Dissecans: Current Treatment Options

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