An uncommon chronic osteochondral defect in the lateral tibial plateau detected after a separate injury

Abstract

Osteochondral defects (OCD) are rare conditions that usually present in young adolescents. The causes include trauma, inflammation, ischaemia, genetics and changes at secondary ossification centres. The case report presents a 27-year-old man with chronic intermittent left knee pain for about 3 years. He typically develops the symptom after prolonged standing or when rising from a prolonged seated position. An initial MRI scan in 2014 did not identify and report an OCD that was present in his left lateral tibial plateau. It was only after an accidental tibial fracture injury this year that the defect was incidentally detected on a scan. OCD can be staged based on MRI and/or arthroscopic findings. The treatment can be either non-operative or operative, but this largely depends on the age of the patient, the severity of symptoms and the staging of the defect.

Bilateral osteochondral defects of the patellae in an 11-year-old girl

“…[5] However, some OCDs remain undetected and untreated until later adult life when a poorer prognosis is expected. [6] The most common site for juvenile OCD in the knee is in the posterolateral aspect of the medial femoral condyle. [7,8,9] A study by Hefti et al showed 77% of lesions affected the medial femoral condyle (lateral aspect 51%, central aspect 19% and medial aspect 7%), 17% affected the lateral femoral condyle, 7% affected the patella, 1% affected the trochlea and only 0.2% affected the tibial plateau.…”