Relationship between tibial spine size and the occurrence of osteochondritis dissecans: an argument in favour of the impingement theory

Cavaignac, Étienne; Perroncel, Geoffroy; Thépaut, Mathias; Vial, J.; Accadbled, Franck; Gauzy, Jérôme Sales de

doi:10.1007/s00167-015-3907-y

Cited by 24 publications

(19 citation statements)

References 31 publications

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“…Although this theory fails to account for OCD lesions at other sites, it has been subsequently advocated by several authors, thus suggesting that impingement is a valid explanation for OCD in specific joint locations. 49,63,67,73,84…”

Section: Discussionmentioning

confidence: 99%

Osteochondritis Dissecans of the Knee: Etiology and Pathogenetic Mechanisms. A Systematic Review

et al. 2018

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Objective The purpose of this manuscript is to analyze the evidence regarding etiopathogenesis of knee osteochondritis dissecans (OCD) lesions through a systematic review, so to summate the current understanding of the origin and progression of this pathologic articular processes. Design A systematic review of the literature was performed on the PubMed and Cochrane databases on October 2017 by 2 independent authors and included all levels of evidence. This included all English language literature, pertaining specifically to etiopathology of knee OCD with exclusions for review articles and expert opinion. Of 965 identified records, 154 full-text articles were assessed for eligibility and 86 studies met the inclusion criteria. Results According to these studies, the etiology of OCD can be of a biological or mechanical origin: 40 articles proposed a biological hypothesis, including genetic causes (27), ossification center deficit (12), and endocrine disorders (9); conversely, 52 articles supported a mechanical hypothesis, including injury/overuse (18), tibial spine impingement (5), discoid meniscus (16), and biomechanical alterations (20) as the cause of the onset of OCD. The pathogenic processes were investigated by 36 of these articles, with a focus on subchondral bone fracture and ischemia as the ultimate events leading to OCD. Conclusions Biological and mechanical factors are found to result in subchondral bone remodeling alterations, acting independently or more likely synergically in the progression of knee OCD. The former includes genetic causes, deficit of ossification centers and endocrine disorders; the latter, tibial spine impingement, discoid meniscus, and biomechanical alterations, together with injuries and overuse. The resultant subchondral bone ischemia and/or fracturing appears to determine the onset and progression of OCD. Level of Evidence Systematic review of level II-IV studies, level IV.

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Section: Discussionmentioning

confidence: 99%

Osteochondritis Dissecans of the Knee: Etiology and Pathogenetic Mechanisms. A Systematic Review

et al. 2018

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“…This is consistent with ICCs reported in previous studies using the same measurement techniques. 5,12,15,26,27,30,44 Femoral Notch Width. The width of the femoral notch was measured in the coronal plane, parallel to a line along the most inferior aspects of the femoral condyles.…”

Section: Anatomic Index Measurementsmentioning

confidence: 99%

“…12 Tibial Spine Height. The height of the medial and lateral tibial spines were measured in the coronal plane using the technique described by Cavaignac et al 5 Briefly, the coronal slice in which the entire height of the tibial spine was visible was used for analysis. The height of the medial and lateral tibial spines were measured as the perpendicular distance from the peak of each spine and a line connecting the peak points on the medial and lateral aspects of the plateau (Figure 1).…”

Section: Anatomic Index Measurementsmentioning

confidence: 99%

Sex Differences in Anatomic Features Linked to Anterior Cruciate Ligament Injuries During Skeletal Growth and Maturation

Hosseinzadeh

Kiapour

2020

Am J Sports Med

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Background: Several anatomic features of the knee have been shown to affect joint and anterior cruciate ligament (ACL) loading and the risk of subsequent injuries. While several studies have highlighted sex differences between these anatomic features, little is known on how these differences develop during skeletal growth and maturation. Hypotheses: (A) Anatomic features linked to an ACL injury will significantly change during skeletal growth and maturation. (B) The age-related changes in anatomic features linked to an ACL injury are different between male and female patients. Study Design: Cross-sectional study; Level of evidence, 3 Methods: After institutional review board approval, magnetic resonance imaging data from 269 unique knees (patient age 3-18 years; 51% female), free from any injuries, were used to measure femoral notch width, posterior slope of the lateral tibial plateau (lateral tibial slope), medial tibial depth, tibial spine height, and posterior lateral meniscal bone angle. Linear regression was used to test the associations between age and quantified anatomic indices. Patients were then divided into 4 age groups: preschool (3-6 years), prepubertal (7-10 years), early adolescent (11-14 years), and late adolescent (15-18 years). Also, 2-way analysis of variance with the Holm-Sidak post hoc test was used to compare morphology between male and female patients in each age group. Results: The femoral notch width, medial tibial depth, and tibial spine height significantly increased with age ( P < .001). The lateral tibial slope decreased with age only in male patients ( P < .001). Except for the posterior lateral meniscal bone angle, the age-related changes in anatomy were different between male and female patients ( P < .05). On average, early and late adolescent female patients had smaller femoral notches, steeper lateral tibial slopes, flatter medial tibial plateaus, and shorter tibial spines compared with age-matched male patients ( P < .01). Conclusion: Overall, the findings supported our hypotheses, showing sex-specific changes in anatomic features linked to an ACL injury during skeletal growth and maturation. These observations help to better explain the reported age and sex differences in the prevalence of ACL injuries. The fact that most of these anatomic features undergo substantial changes during skeletal growth and maturation introduces the hypothesis that prophylactic interventions (ie, activity modification) would have the potential to reshape a maturing knee in a manner that lowers the risk of noncontact ACL injuries.

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“…13,25 In cases involving the ‘classic’ OCD site at the medial femoral condyle, the repetitive microtrauma may be caused by tibial spine impingement. 10,26 Biomechanical factors, including obesity, 4 lower-limb alignment abnormalities, 5 soft-tissue instability 27 and knee activity-related positioning, have also been implicated. 28 Anatomic variation in the lateral femoral condyle 29 and posterior cruciate ligament morphology, 30 as well as the presence of a discoid meniscus, 31 may further affect the mechanical environment in the knee.…”

Section: Aetiologymentioning

confidence: 99%

“…2 The causes of OCD are unknown; however, repetitive trauma, inflammation, accessory centres of ossification, ischaemia and genetic factors has been proposed. 3–10 The clinical presentation of JOCD is highly variable, with some children being completely asymptomatic. Pain can be poorly localized in nature; there may also be associated joint swelling and mechanical symptoms.…”

Section: Introductionmentioning

confidence: 99%

Juvenile osteochondritis dissecans (JOCD) of the knee: current concepts review

Masquijo

Kothari

2019

EFORT Open Reviews

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Juvenile osteochondritis dissecans (JOCD) is a joint disorder of the subchondral bone and articular cartilage that affects skeletally immature patients. The aetiology of JOCD is unknown and the natural history is poorly characterized in part due to inconsistent and largely retrospective literature. Most OCD in children and adolescents presents as a stable lesion amenable to non-operative treatment or minimally invasive drilling. However, unstable forms can require a more aggressive approach. This article reviews the most recent literature available and focuses on the pathophysiology, diagnosis and treatment of JOCD of the knee. Cite this article: EFORT Open Rev 2019;4:201-212. DOI: 10.1302/2058-5241.4.180079

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Relationship between tibial spine size and the occurrence of osteochondritis dissecans: an argument in favour of the impingement theory

Abstract: IV.

Cited by 24 publications

References 31 publications

Osteochondritis Dissecans of the Knee: Etiology and Pathogenetic Mechanisms. A Systematic Review

Osteochondritis Dissecans of the Knee: Etiology and Pathogenetic Mechanisms. A Systematic Review

Sex Differences in Anatomic Features Linked to Anterior Cruciate Ligament Injuries During Skeletal Growth and Maturation

Juvenile osteochondritis dissecans (JOCD) of the knee: current concepts review

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