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Higuera, José Luis Vázquez; Laguna, Reinaldo; Peral, M Del; Aranda, Ester Badia; Soleto, J

doi:10.1097/00004694-199805000-00011

Cited by 19 publications

(8 citation statements)

References 13 publications

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“…Due to the small sample numbers, statistically significant conclusions could not be reached based on lesions of the trochlea (3 of 4), tibial plateau (1 of 1), and patella (1 of 3) that progressed to surgery. However, our results indirectly support the findings of several authors who, though not necessarily documenting a lower rate of surgery in MFC lesions, have noted either a greater rate of healing in MFC lesions 9 or better clinical results in classic MFC lesions in the central or lateral MFC 21 as opposed to lesions elsewhere in the knee.…”

Section: Discussionsupporting

confidence: 91%

“…The literature is quite variable regarding progression to surgery for ankle OCD, with a surgical intervention rate between 19% and 58% in multiple studies. 11 , 21 , 32 Looking specifically at children, Letts et al 32 found a surgical intervention in only 1 of 5 in children under the age of 12 years, Higuera et al 21 found a 33% surgical intervention rate in their study of pediatric ankle OCD, and the 20-year follow-up study by Bauer et al 11 on ankle OCD in a mixture of children and adults found that only 1 of 5 children had surgery. As with knee OCD, surgical progression for ankle OCD did not significantly differ based on either sex and, in contrast to knee OCD, location within the ankle did not seem to correlate with nonoperative treatment failure.…”

Section: Discussionmentioning

confidence: 99%

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The Incidence of Surgery in Osteochondritis Dissecans in Children and Adolescents

Weiss

Nikizad

Shea

et al. 2016

Orthopaedic Journal of Sports Medicine

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Background:The frequency of osteochondritis dissecans (OCD), a disorder of the subchondral bone and articular cartilage, is not well described.Purpose:To assess the frequency of pediatric OCD lesions that progress to surgery based on sex, joint involvement, and age.Study Design:Descriptive epidemiology study.Methods:A retrospective chart review (2007-2011) was performed on OCD. Inclusion criteria included OCD of any joint and patients aged 2 to 19 years. Exclusion criteria included traumatic osteochondral fractures or coexistence of non-OCD intra-articular lesions. Differences in progression toward surgery were compared between age groups, sex, and joint location. Logistical regression analysis was performed by sex, age, and ethnicity.Results:Overall, 317 patients with a total of 334 OCD lesions were found. The majority of lesions (61.7%) were in the knee, with ankle, elbow, shoulder, and foot lesions representing 25.4%, 12.0%, 0.6%, and 0.3% of all lesions, respectively. The majority of joints needing surgery were in the knee (58.5%), with ankle and elbow lesions representing 22.9% and 18.6% of surgeries performed, respectively. The percentage of all OCD lesions progressing to surgery was 35.3%; surgical progression for knee, ankle, and elbow joints was 33.5%, 31.8%, and 55.0%, respectively. Logistic regression analysis found no statistically significant different risk of progressing to surgery for OCD of the knee, elbow, and ankle between sexes. Patients aged 12 to 19 years had a 7.4-times greater risk of progression to surgery for knee OCD lesions than 6- to 11-year-olds. Patients aged 12 to 19 years were 8.2 times more likely to progress to surgery for all OCD lesions than patients aged 6 to 11 years. Progression to surgery of ankle OCD did not significantly differ based on location. Three of 4 trochlear lesions progressed to surgery, along with 1 of 1 tibial, 1 of 3 patellar, 40.3% of lateral femoral condylar, and 28.2% of medial femoral condylar lesions.Conclusion:In this large cohort study of pediatric OCD patients, 35% progressed to surgery. Progression to surgery did not differ significantly between sexes with OCD of any joint. Progression to surgery for OCD of the knee, elbow, and ankle strongly correlated with patient age at the time of diagnosis.Clinical Relevance:The knowledge of likelihood of progression to surgery of OCD by location, sex, and age is useful in counseling patients and in planning treatment. This study confirms a worse prognosis in the nonoperative treatment of older patients with OCD.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

The Incidence of Surgery in Osteochondritis Dissecans in Children and Adolescents

Weiss

Nikizad

Shea

et al. 2016

Orthopaedic Journal of Sports Medicine

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“…Repetitive, excessive compression of the subchondral bone caused by stress and trauma can result in OCD [ 2 ]. The condition wherein compression force is applied to the talar posterior calcaneal articular surface is similar to that of a fracture of the talar lateral process.…”

Section: Discussionmentioning

confidence: 99%

“…It is also called an osteochondral lesion. Repetitive, excessive compression of the subchondral bone caused by stresses or trauma can result in OCD [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Bilateral Osteochondritis Dissecans of the Talar Posterior Calcaneal Articular Surface in a Professional Soccer Player: A Case Report

Yanagisawa¹,

Ishii²,

Yamazaki³

2021

JOCR

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Introduction: Preferred sites of osteochondritis dissecans (OCD) are the distal femur and humerus, and the dome of the talus. We report a rare case of a professional soccer player with bilateral OCD of the talar posterior calcaneal articular surface. Case Report: The left talus showed a loose but not displaced fragment, and pain was relieved with 3 months of conservative treatment. The right had two loose fragments that were displaced from their beds in the talar posterior calcaneal articular surface. The loose bodies were surgically excised. The player remains symptom free 4 years after the operation and participates in professional games. Thus, although OCD of the talar posterior calcaneal articular surface remains a relatively uncommon injury, we suggest that treatment methods tailored to the OCD stage as per Berndt and Harty classification may be successful. The exact causes and establishment of a treatment protocol in these cases will depend on the investigation of future cases. Conclusion: Since this case of OCD of the talar posterior calcaneal articular surface was bilateral, we hypothesized that it may have been caused by microtrauma in the sense of repetitive, excessive compression of the subchondral bone, or by a vascular etiology. Keywords: Case report, lateral hindfoot pain, osteochondral lesion, subtalar articular facet, subtalar joint.

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“…Ischemia of the subchondral bone causes separation of the fragment from the underlying bed. Osteochondral lesions of the talus occur anterolaterally, but posteromedial lesions are more common and account for 74% of these lesions 13. Central lesions are rare.…”

Section: Talar Osteochondral Injuriesmentioning

confidence: 99%

Management of foot and ankle injuries in pediatric and adolescent athletes: a narrative review

Gill¹,

Klingele²

2018

ORR

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In this review, we focus on the treatment of injuries to the foot and ankle in the adolescent athlete. While many injuries in the adolescent foot and ankle are similar to or overlap with their counterparts in the adult population, the anatomy of the adolescent ankle, especially the presence of growth plates, results in different injury patterns in many cases and calls for specific management approaches. We discuss the unique anatomy of the pediatric patient as well as the diagnostic evaluation and treatment of common injuries in the young athlete.

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Cited by 19 publications

References 13 publications

The Incidence of Surgery in Osteochondritis Dissecans in Children and Adolescents

The Incidence of Surgery in Osteochondritis Dissecans in Children and Adolescents

Bilateral Osteochondritis Dissecans of the Talar Posterior Calcaneal Articular Surface in a Professional Soccer Player: A Case Report

Management of foot and ankle injuries in pediatric and adolescent athletes: a narrative review

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