Osteochondritis Dissecans of the Knee: Treatment of Juvenile and Adult Forms

@article{Cahill1995OsteochondritisDO,
  title={Osteochondritis Dissecans of the Knee: Treatment of Juvenile and Adult Forms},
  author={Bernard R. Cahill},
  journal={Journal of the American Academy of Orthopaedic Surgeons},
  year={1995},
  volume={3},
  pages={237–247}
}
  • B. Cahill
  • Published 1 July 1995
  • Medicine
  • Journal of the American Academy of Orthopaedic Surgeons
&NA; Osteochondritis dissecans (OCD) and juvenile osteochondritis dissecans (JOCD) are distinct entities that require different management. Although both conditions result from stress fractures of the subchondral bone, JOCD has a much better prognosis; treated conservatively, 50% of cases will heal, probably providing a normal knee during adult life. In contrast, OCD often is followed by the early onset of degenerative arthritis. The treatment of JOCD and OCD, whether nonoperative or operative… 
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Osteochondritis dissecans is a disease that originates in the subchondral bone that affects the articular cartilage. It generally presents gradually and is associated with non-specific symptoms. The
Osteochondritis dissecans of the tarsal navicular bone: a case report.
TLDR
A case of osteochondritis dissecans of the talonavicular joint affecting the concave part of the tarsal navicular bone in a 22-year-old woman is reported, which was successfully treated by surgery, leading to complete recovery.
Osteochondritis dissecans of the knee in children and adolescents
TLDR
Indications for surgical treatment are based on lesion stability, skeletal maturity, and clinical symptoms, which include establishing the joint surface, improving the blood supply of the fragment, rigid fixation, and early motion are primary goals for osteochondral fragment preservation.
Pediatric Knee Osteochondritis Dissecans Lesions.
TLDR
The goals of surgical treatment include maintenance of articular cartilage congruity, rigid fixation of unstable fragments, and repair of osteochondral defects with cells or tissues that can adequately replace lost or deficient cartilage.
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References

SHOWING 1-10 OF 19 REFERENCES
Osteochondritis dissecans of the knee. A clinical survey.
  • P. Aichroth
  • Medicine
    The Journal of bone and joint surgery. British volume
  • 1971
TLDR
The outstanding etiological feature was found to be direct injury to the joint surface, repeated injuries sustained in first class athletics and field sports, and mechanical abnormalities of the knee.
Osteochondritis dissecans. History, pathophysiology and current treatment concepts.
TLDR
The past and current status of osteochondritis dissecans suggests that there is still no clear cut etiology and the existence of two clinical patterns is important.
Treatment of osteochondritis dissecans.
  • I. Smillie
  • Medicine
    The Journal of bone and joint surgery. British volume
  • 1957
TLDR
An attempt to treat osteochondritis dissecans on idealistic lines has been presented, the radiological appearance has become virtually normal, healing has been observed directly in seven cases, and complaints have been eliminated, but the long term results of treatment are unknown.
Osteochondritis dissecans 1887-1987. A centennial look at König's memorable phrase.
  • H. Barrie
  • Medicine
    The Journal of bone and joint surgery. British volume
  • 1987
In 1887, König claimed that loose bodies in the knee joints of young persons had three causes: (1) very severe trauma; (2) lesser trauma causing contusion and necrosis; and (3) minimal trauma acting
The incidence of osteochondritis dissecans in the condyles of the femur.
  • B. Lindén
  • Medicine
    Acta orthopaedica Scandinavica
  • 1976
The incidence of osteochondritis dissecans in the condyles of the femur was studied in a defined population and was found to be twice as common in men as in women; the maximum incidence in both sexes
Osteochondritis dissecans of the femoral condyles.
TLDR
It was found that knees with osteochondritis dissecans of the femoral condyles that had no other abnormal physical findings or functional disability responded well to conservative treatment before epiphyseal closure.
The Results of Conservative Management of Juvenile Osteochondritis Dissecans Using Joint Scintigraphy. A Prospective Study Bernard R. Cahill, MD, Mark R. Phillips, MD, Ronald Navarro, MD-Peoria, Illinois
We retrospectively reviewed 100 consecutive patients who underwent MRI of the knee, followed by arthroscopic (97) or open knee surgery (3). The MRI, plain radiographs, and arthroscopic findings were
Computerized blood flow analysis for decision making in the treatment of osteochondritis dissecans.
TLDR
The noninvasive technique of computerized blood flow analysis (CBFA) has been used in 13 patients with OCD and holds promise for decision making in the management of this disease.
Fresh Osteochondral Allografting of the Femoral Condyle
Fresh osteochondral shell allografting is conceived as an interim response to the localized loss of articular cartilage in young patients for whom there is no reasonable alternative after
99m-Technetium phosphate compound joint scintigraphy in the management of juvenile osteochondritis dissecans of the femoral condyles
TLDR
Joint scintigraphy is valuable in the management of OCD because of its superior sensitivity to changes in the activity of the lesion, and precedes changes seen on standard x-rays by months.
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