Management of Osteochondritis Dissecans of the Knee

@article{Kocher2006ManagementOO,
  title={Management of Osteochondritis Dissecans of the Knee},
  author={Mininder S Kocher and Rachael Tucker and Theodore J Ganley and John M Flynn},
  journal={The American Journal of Sports Medicine},
  year={2006},
  volume={34},
  pages={1181 - 1191}
}
Osteochondritis dissecans of the knee is being seen with increased frequency in pediatric and young adult athletes and is thought to be, in part, owing to earlier and increasingly competitive sports participation. Despite much speculation, the cause of both juvenile and adult osteochondritis dissecans remains unclear. Early recognition is essential. Whereas adult osteochondritis dissecans lesions have a greater propensity to instability, juvenile osteochondritis dissecans lesions are typically… Expand
Juvenile Osteochondritis Dissecans of the Knee
TLDR
Damaged and unsalvageable jOCD lesions or displaced j OCD lesions devoid of subchondral bone are generally treated initially with debridement and abrasion arthroplasty (microfracture). Expand
[Osteochondritis dissecans of the knee].
TLDR
Most adult type osteochondritis dissecans patients, as most young patients, with unstable lesions and loose bodies within their knees, are treated with fixation of the lesions and even bone grafting, but the long-term prognosis is elusive. Expand
The Knee: Osteochondritis Dissecans
TLDR
Operative intervention is reserved for stable lesions that do not heal after 6–9 months of conservative management, for large stable lesions in children approaching skeletal maturity and for most unstable lesions especially if symptomatic. Expand
Management strategies for osteochondritis dissecans of the knee in the skeletally immature athlete.
TLDR
It is recommended that rehabilitation of JOCD be tailored to the individual patient, based on the stage and radiographic status of the lesion and the mode of surgery employed when surgically addressed. Expand
Osteochondritis Dissecans of the Knee
TLDR
The overall goal for the treatment of adult OCD lesions is to relieve pain, restore function, and prevent development of secondary osteoarthritis. Expand
Osteochondritis Dissecans: Current Understanding of Epidemiology, Etiology, Management, and Outcomes.
TLDR
Treatment largely depends on skeletal maturity and lesion stability, defined by the presence or absence of articular cartilage fracture and subchondral bone separation, as determined by imaging and arthroscopy, and is typically nonoperative for stable lesions in skeletally immature patients and operative for those who have had failure of conservative management or have unstable lesions. Expand
Management of Symptomatic Osteochondritis Dissecans of the Knee
TLDR
This infographic reviews the presentation and description of different types of OCD lesions, prognostic factors, surgical indications, and considerations for determining the optimal treatment algorithm. Expand
Grade I Osteochondritis Dissecans in a Young Professional Athlete
TLDR
The objective of this study is to determine the best mode of management of a Grade I osteochondritis lesion in a young athlete and recommend initial nonoperative line of management in patients with open physis. Expand
Osteochondritis dissecans of the knee: a practical guide for surgeons.
TLDR
An algorithm for treatment is presented, which aims to promote healing of native hyaline cartilage and to ensure joint congruity and to establish the stability of the lesion. Expand
Osteochondritis Dissecans of the Knee: Pathophysiology and Treatment
TLDR
This chapter discusses common surgical treatment options for OCD including retro- and transarticular drilling, stabilization of the lesions with metallic and/or bioabsorbable screws, microfracture, osteochondral autograft transfer system (OATS), autologous chondrocyte implantation (ACI), and newer cartilage treatment techniques. Expand
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References

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Osteochondritis (osteochondrosis) dissecans: A review and new MRI classification
TLDR
MRI can noninvasively separate non-surgical from possibly surgical lesions and should replace diagnostic arthroscopy, and will become the method of choice for staging. Expand
Arthroscopic surgical management of osteochondritis dissecans of the knee.
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TLDR
This paper presents a series of 29 patients who were treated surgically for symptomatic osteochondritis dissecans using arthroscopic techniques and indicates a 72% satisfactory result rate when both subjective and objective means of measuring the results are considered. Expand
Osteochondritis dissecans of the knee in children. A comparison of MRI and arthroscopic findings.
TLDR
It is concluded that MRI can be used to stage OCD lesions accurately and that a high signal line behind the OCD fragment does not always indicate instability, and that an MRI classification system which correlates with the arthroscopic findings is recommended. Expand
Biodegradable Rods in Adult Osteochondritis Dissecans of the Knee
TLDR
Internal fixation of osteochondritis dissecans of the knee with biodegradable polylactic rods provided satisfactory control of symptoms in the short term and resulted in radiographically stable lesions in eight of nine patients. Expand
Osteochondritis Dissecans of the Knee: Treatment of Juvenile and Adult Forms
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TLDR
The treatment of JOCD and OCD, whether nonoperative or operative, should be based on the principles of fracture treatment, because surgical correction of either of these conditions is unlikely to succeed unless the joint surface is perfectly restored. Expand
Cartilage and bone morphology in osteochondritis dissecans
TLDR
Thirty human osteochondral cylinders from patients with osteochondritis dissecans of the medial femoral condyle were harvested intraoperatively from osteochondritic areas as part of a cartilage-bone transplantation, revealing differences between osteochondrotic and normal cartilage. Expand
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TLDR
In this series, Wilson's sign was of minimal clinical diagnostic value, but when positive, the sign is useful as a clinical monitor during treatment. Expand
Cylindrical Osteochondral Graft for Osteochondritis Dissecans of the Knee
TLDR
Between 1995 and 1997, three patients with osteochondritis dissecans were treated using a 10-mm diameter cylindrical osteochondral graft to both internally fix and allow repair of the fragment, consistent with the concept of biologic internal fixation. Expand
The results of conservative management of juvenile osteochondritis dissecans using joint scintigraphy
TLDR
A prospective clinical study used joint scintigraphy to investigate conservative treatment of juvenile osteo chondritis dissecans (JOCD) of the femoral condyle and found that based on specific indications for failure of conserva tive treatment, 50% of these patients failed and under went surgery. Expand
Functional and Radiographic Outcome of Juvenile Osteochondritis Dissecans of the Knee Treated with Transarticular Arthroscopic Drilling *
TLDR
Given the low morbidity of drilling and the associated improvement in functional and radiographic outcomes, this study advocate arthroscopic transarticular drilling for patients with juvenile osteochondritis dissecans of the medial femoral condyle with an intact articular surface who have had failure of initial nonoperative management. Expand
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