Osteochondritis dissecans of the knee: Imaging, instability concept, and criteria

Accadbled, Franck; Turati, Marco; Kocher, Mininder S.

doi:10.1177/18632521221149054

Cited by 5 publications

(4 citation statements)

References 19 publications

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“…It is important to distinguish knee OCD from the normal variation in irregular contours on the posterior femoral condyle, which is commonly observed in patients with open growth plates (physes), particularly between the ages of 6 and 10. Unlike OCD, this normal irregularity does not exhibit a surrounding sclerotic rim and tends to become less pronounced over time [40].…”

Section: Radiographymentioning

confidence: 95%

“…The "Oreo cookie sign" in MRI imagery is characterized by a curvilinear hyperintense T2 signal at the interface of the progeny and the parent bone (resembling the cream of an Oreo cookie), flanked by two layers of hypointense signals (similar to the cookie wafers). The presence of focal cysts at the interface between the progeny and the parent bone indicates a more chronic condition [40].…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

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Understanding Osteochondritis Dissecans: A Narrative Review of the Disease Commonly Affecting Children and Adolescents

Konarski,

Poboży,

Konarska

et al. 2024

Children

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Background: Osteochondritis dissecans (OCD) is a joint disorder predominantly affecting the knee, elbow, and ankle of children and adolescents. This comprehensive review delves into the epidemiology, etiology, clinical manifestations, diagnostic approaches, and treatment of OCD. Results: The most common cause of OCD is repetitive microtrauma, typically associated with sports activities, alongside other significant factors such as genetic predisposition, ischemia, and obesity. In early stages or when lesions are small, OCD often presents as non-specific, vaguely localized pain during physical activity. As the condition progresses, patients may experience an escalation in symptoms, including increased stiffness and occasional swelling, either during or following activity. These symptom patterns are crucial for early recognition and timely intervention. Diagnosis in most cases is based on radiographic imaging and magnetic resonance imaging. Nonsurgical treatment of OCD in young patients with open growth plates and mild symptoms involves activity restriction, immobilization methods, and muscle strengthening exercises, with a return to sports only after symptoms are fully resolved and at least six months have passed. Surgical treatment of OCD includes subchondral drilling in mild cases. Unstable lesions involve methods like restoring the joint surface, stabilizing fractures, and enhancing blood flow, using techniques such as screws, anchors, and pins, along with the removal of fibrous tissue and creation of vascular channels. The specifics of OCD treatment largely depend on the affected site. Conclusions: This synthesis of current research and clinical practices provides a nuanced understanding of OCD, guiding future research directions and enhancing therapeutic strategies.

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Section: Radiographymentioning

confidence: 95%

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Understanding Osteochondritis Dissecans: A Narrative Review of the Disease Commonly Affecting Children and Adolescents

Konarski,

Poboży,

Konarska

et al. 2024

Children

View full text Add to dashboard Cite

show abstract

“…In T1-weighted images, the progeny is typically hypointense, this sequence allows for a detailed analysis of the bone signal and provides measurements for lesion size. In T2-weighted images, the progeny is mostly heterogeneous; this sequence can assess the integrity of articular cartilage, reactive marrow edema in the parent bone, and fluid or cystic changes at the parent-progeny interface [ 45 , 64 ]. The existence of cysts at the interface between the progeny and parent bone indicates OCD chronicity [ 64 ].…”

Section: Clinical Presentation and Diagnosismentioning

confidence: 99%

“…In T2-weighted images, the progeny is mostly heterogeneous; this sequence can assess the integrity of articular cartilage, reactive marrow edema in the parent bone, and fluid or cystic changes at the parent-progeny interface [ 45 , 64 ]. The existence of cysts at the interface between the progeny and parent bone indicates OCD chronicity [ 64 ].…”

Section: Clinical Presentation and Diagnosismentioning

confidence: 99%

A Comparative Analysis of Osteochondritis Dissecans and Avascular Necrosis: A Comprehensive Review

Konarski,

Poboży,

Konarska

et al. 2024

JCM

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Musculoskeletal disorders, standing as the fifth leading cause of disability-adjusted life years globally, present significant challenges in orthopedics. Osteochondritis dissecans (OCD) and avascular necrosis (AVN) are distinct but closely related conditions within this spectrum, impacting patients’ quality of life with pain, limited mobility, and dysfunction. OCD, involving cartilage and bone detachment in joints, predominantly affects young athletes, but its exact etiology and optimal management remain subjects of ongoing research. Conversely, AVN, marked by bone tissue death due to compromised blood supply, is linked to systemic factors like corticosteroid use and traumatic injuries. Diagnosis for both conditions relies on radiography and magnetic resonance imaging. Conservative treatment for AVN includes the use of a cane or crutches, pharmacological therapy, or physical therapy. On the other hand, in OCD, the primary approach is activity/sports restriction. Surgical treatment options for AVN patients encompass core decompression, bone grafting, or, in the most advanced cases, total hip arthroplasty. OCD may be surgically treated through subchondral drilling or fixation of unstable lesions. Advanced cases of OCD involve cartilage salvage with resurfacing techniques. The presentation of differences between these conditions enhances our understanding, facilitating improved diagnosis and management strategies.

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Efficacy of the pridie drilling technique in knee osteochondritis dissecans among children and young adults: follow-up of 41 cases

Unal,

Samargandi,

Olejnik

et al. 2023

Eur J Orthop Surg Traumatol

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Osteochondritis dissecans of the knee: Imaging, instability concept, and criteria

Cited by 5 publications

References 19 publications

Understanding Osteochondritis Dissecans: A Narrative Review of the Disease Commonly Affecting Children and Adolescents

Understanding Osteochondritis Dissecans: A Narrative Review of the Disease Commonly Affecting Children and Adolescents

A Comparative Analysis of Osteochondritis Dissecans and Avascular Necrosis: A Comprehensive Review

Efficacy of the pridie drilling technique in knee osteochondritis dissecans among children and young adults: follow-up of 41 cases

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