Perspective on Idiopathic Subchondral, Osteochondral, and Chondral Lesions with Emphasis on the Knee

Abstract

Subchondral, osteochondral, and chondral lesions of unknown cause are often encountered, especially in the knee joint. These are mainly idiopathic bone marrow edema syndrome, osteochondrosis dissecans, and cartilage delaminations. The literature on these diseases is sparse and often confusing and inconsistent. Because there is little evidence, this article was written as a perspective on these conditions. It offers an overview of the literature with personal comments and opinions based on observations from many years of clinical practice. The main goal is to highlight clinically important features and provide a practical guide for dealing with various magnetic resonance imaging findings in everyday work. The article also discusses several terms commonly used in relation to these diseases and their differential diagnoses.

High-Density Autologous Chondrocyte Implantation (HD-ACI) in patients with bilateral knee chondral defects

“…In the knee, trauma and osteochondritis dissecans are responsible for most cartilage lesions (2,3). Additionally, cartilage lesions of unknown etiology or idiopathic cartilage lesions may also occur (4). Although knee cartilage lesions are mainly located in one limb, some patients have bilateral injuries.…”

Perspective on subchondral insufficiency fracture of the knee

“…Between 50% and 100% of persons with SIFK/SONK have concomitant meniscal injuries [ 3 ], and the relationship between meniscal injuries and SIFK may be causal: disruption of the posterior root of the medial meniscus increases contact pressure between the tibia and femur, which could result in overload of the medial femoral condyle and SIFK [ 2 ]. SIFK may also be a complication of transient bone marrow edema syndrome, also referred to as transient osteoporosis, a condition seen in men aged 40–60 and pregnant women [ 6 ]. SIFK is associated with cartilage damage and development of knee osteoarthritis (OA) [ 7 ].…”