Introduction. The osteochondritis dissecans (OCD) is a pathologic condition of osteochondral tissue predominantly in the femoral condyles, which is met most often in adolescents and which can lead to the formation of early arthrosis in the knee joint in the remote time. By modern concepts, stable OCD foci are the foci with intact articular cartilage without the risk of migration into the joint cavity. To date, there are very few studies in the world literature on the treatment of early stages of osteochondrosis dissecans.Material and methods. Two independent researchers have carried out a systematic review of literature sources (2000-2020 ) using Pubmed, Medline and GoogleScholar. 9 publications were selected for data analysis out of 5184 publications after the qualitative assessment by the Yang scale and the obtained consensus in disputable situations.Results. Statistical analysis of the obtained data with the Statistica program revealed that the average rate of OCD foci healing was seen in 86.7% (from 70.6 to 100%). The most effective outcomes were in the group of antegrade drilling (95.3% of healed foci), then in the group with biodegradable implants fixation (88.5%), then the group of antegrade drilling with the introduction of bone marrow aspirate concentrate (BMAC) - 76.9%, and then the retrograde drilling - 76.8%.Conclusion. The analysis performed have shown a significant heterogeneity in data reporting, different methods for diagnosing osteochondritis dissecans, different approaches to healing assessment as well as a small number of children in samples what determined the lack of statistical significance between different options of surgical treatment (p = 0.27). Carefully planned trials with a proper design, standardized techniques for healing assessment and time of their application as well as the assessment of comparison groups and of all other necessary factors affecting lesion healing are needed.
Osteochondritis dissecans (OCD) of the knee is a pathological condition of subchondral bone resembling focal osteolysis with subsequent bone resorption, which may lead to osteochondral fragment separation. Several etiological concepts reported for OCD development. The multifactorial theory is commonly adopted for days. Different investigators report OCD lesion healing while using conservative treatment or even “waitful watching” with a healing rate of up to 67%. In spite of these results, there are not any commonly adopted guidelines for conservative treatment. The last stage of OCD is a separation of osteochondral fragment leaving a full-thickness osteochondral defect, which is usually filled with low-quality fibrocartilaginous tissue. This tissue provides a lesser extent of resistance to peak loading forces, which poses at risk subchondral bone for further destruction and early osteoarthritis development. Appropriate treatment method should be chosen for each OCD stage in order to prevent early osteoarthritis development, increase return-to-sport rate, and decrease healing time for OCD lesions. This chapter provides short but comprehensive to date knowledge about OCD on the knee of adolescents and young adults.
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