Abstract
Osteochondritis dissecans (OCD) is a common cause of knee pain and dysfunction in both adult and skeletally immature patients. OCD is a focal lesion of subchondral bone and subsequently the overlying articular cartilage. Classically thought to be an acquired idiopathic lesion, OCD can lead to articular cartilage softening, swelling, delamination, partial detachment, and potentially complete osteochondral separation resulting in a loose body. The instability and cartilage damage that OCD lesions impart, as well as third body wear from resulting loose bodies, may contribute to premature osteoarthritis. When treating stable, juvenile OCD, the majority of patients can achieve a favorable outcome with conservative, non-operative management. Surgical intervention is dependent on lesion stability, physeal status, and clinical symptoms. Surgical intervention types can be separated into palliative, reparative, and restorative techniques. The overall goal for the treatment of OCD lesions is to relieve pain, reduce mechanical symptoms, and prevent development of secondary osteoarthritis.
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References
Pascual-Garrido C, McNickle AG, Cole BJ. Surgical treatment options for osteochondritis dissecans of the knee. Sports Health. 2009;1:326–34.
Yang JS, Bogunovic L, Wright RW. Nonoperative treatment of osteochondritis dissecans of the knee. Clin Sports Med. 2014;33:295–304.
Trinh TQ, Harris JD, Flanigan DC. Surgical management of juvenile osteochondritis dissecans of the knee. Knee Surg Sports Traumatol Arthrosc Off J ESSKA. 2012;20:2419–29.
Kocher MS, Tucker R, Ganley TJ, Flynn JM. Management of osteochondritis dissecans of the knee: current concepts review. Am J Sports Med. 2006;34:1181–91.
Kessler JI, Nikizad H, Shea KG, Jacobs JC, Bebchuk JD, Weiss JM. The demographics and epidemiology of osteochondritis dissecans of the knee in children and adolescents. Am J Sports Med. 2014;42:320–6.
Jacobs JC, Archibald-Seiffer N, Grimm NL, Carey JL, Shea KG. A review of arthroscopic classification systems for osteochondritis dissecans of the knee. Clin Sports Med. 2014;33:189–97.
Erickson BJ, Chalmers PN, Yanke AB, Cole BJ. Surgical management of osteochondritis dissecans of the knee. Curr Rev Musculoskelet Med. 2013;6:102–14.
Cavaignac E, Perroncel G, Thépaut M, Vial J, Accadbled F, De Gauzy JS. Relationship between tibial spine size and the occurrence of osteochondritis dissecans: an argument in favour of the impingement theory. Knee Surg Sports Traumatol Arthrosc Off J ESSKA. 2017;25:2442–6.
Kon E, Vannini F, Buda R, et al. How to treat osteochondritis dissecans of the knee: surgical techniques and new trends: AAOS exhibit selection. J Bone Joint Surg Am. 2012;94:e1(1–8).
Hefti F, Beguiristain J, Krauspe R, et al. Osteochondritis dissecans: a multicenter study of the European pediatric orthopedic society. J Pediatr Orthop B. 1999;8:231–45.
Gomoll AH, Flik KR, Hayden JK, Cole BJ, Bush-Joseph CA, Bach BR. Internal fixation of unstable Cahill Type-2C osteochondritis dissecans lesions of the knee in adolescent patients. Orthopedics. 2007;30:487–90.
Dipaola JD, Nelson DW, Colville MR. Characterizing osteochondral lesions by magnetic resonance imaging. Arthroscopy. 1991;7:101–4.
Brittberg M, Winalski CS. Evaluation of cartilage injuries and repair. J Bone Joint Surg Am. 2003;85-A Suppl 2:58–69.
De Smet AA, Ilahi OA, Graf BK. Untreated osteochondritis dissecans of the femoral condyles: prediction of patient outcome using radiographic and MR findings. Skelet Radiol. 1997;26:463–7.
Pascual-Garrido C, Moran CJ, Green DW, Cole BJ. Osteochondritis dissecans of the knee in children and adolescents. Curr Opin Pediatr. 2013;25:46–51.
Edmonds EW, Polousky J. A review of knowledge in osteochondritis dissecans: 123 years of minimal evolution from König to the ROCK study group. Clin Orthop Relat Res. 2013;471:1118–26.
Shea KG, Jacobs JC, Carey JL, Anderson AF, Oxford JT. Osteochondritis dissecans knee histology studies have variable findings and theories of etiology. Clin Orthop Relat Res. 2013;471:1127–36.
Cruz AI, Shea KG, Ganley TJ. Pediatric knee osteochondritis Dissecans lesions. Orthop Clin North Am. 2016;47:763–75.
Bruns J, Werner M, Habermann C. Osteochondritis Dissecans: etiology, pathology, and imaging with a special focus on the knee joint. Cartilage. 2018;9:346–62. https://doi.org/10.1177/1947603517715736.
Linden B. The incidence of osteochondritis dissecans in the condyles of the femur. Acta Orthop Scand. 1976;47:664–7.
Anderson AF, Pagnani MJ. Osteochondritis dissecans of the femoral condyles. Long-term results of excision of the fragment. Am J Sports Med. 1997;25:830–4.
Abouassaly M, Peterson D, Salci L, et al. Surgical management of osteochondritis dissecans of the knee in the paediatric population: a systematic review addressing surgical techniques. Knee Surg Sports Traumatol Arthrosc Off J ESSKA. 2014;22:1216–24.
Winthrop Z, Pinkowsky G, Hennrikus W. Surgical treatment for osteochondritis dissecans of the knee. Curr Rev Muscoskelet Med. 2015;8:467–75.
Richter DL, Schenck RC Jr, Wascher DC, Treme G. Knee articular cartilage repair and restoration techniques: a review of the literature. Sports Health. 2016;8:153–60.
Gudas R, Kalesinskas RJ, Kimtys V, et al. A prospective randomized clinical study of mosaic osteochondral autologous transplantation versus microfracture for the treatment of osteochondral defects in the knee joint in young athletes. Arthroscopy. 2005;21:1066–75.
Bartlett W, Gooding CR, Carrington RW, Skinner JA, Briggs TW, Bentley G. Autologous chondrocyte implantation at the knee using a bilayer collagen membrane with bone graft. A preliminary report. J Bone Joint Surg Br. 2005;87:330–2.
Peterson L, Minas T, Brittberg M, Lindahl A. Treatment of osteochondritis dissecans of the knee with autologous chondrocyte transplantation: results at two to ten years. J Bone Joint Surg Am. 2003;85-A Suppl 2:17–24.
Pascual-Garrido C, Friel NA, Kirk SS, et al. Midterm results of surgical treatment for adult osteochondritis dissecans of the knee. Am J Sports Med. 2009;37(Suppl 1):125S–30S.
Sadr KN, Pulido PA, McCauley JC, Bugbee WD. Osteochondral allograft transplantation in patients with osteochondritis dissecans of the knee. Am J Sports Med. 2016;44:2870–5.
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Redondo, M.L., Beer, A.J., Yanke, A.B. (2019). Osteochondritis Dissecans of the Knee. In: Yanke, A., Cole, B. (eds) Joint Preservation of the Knee. Springer, Cham. https://doi.org/10.1007/978-3-030-01491-9_9
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