Osteochondrosis Dissecans

Pappas, Arthur M.

doi:10.1097/00003086-198107000-00009

Cited by 160 publications

(64 citation statements)

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“…Osteochondritis dissecans (OCD), a term introduced by König in 1887 [1], is a rare lesion that affects the articular cartilage and the epiphyseal bone and may result in lack of consolidation to the separation of osteochondral fragment [2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Juvenile osteochondritis of femoral condyles: Treatment with transchondral drilling. Analysis of 40 cases

Rammal

Phillipe

Schneider

et al. 2010

Journal of Children's Orthopaedics

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Introduction Osteochondritis dissecans (OCD) of the femoral condyle is a rare lesion. Materials and methods A retrospective study (level IV evidence) analyzing a series of 40 pediatric cases with juvenile femoral condyles osteochondritis treated by arthroscopic multiple transchondral drilling between February 1999 and June 2008 was undertaken. This lesion affected the medial condyle in 87.5% of cases. The average age at treatment was 13.4 years. Our study took into account the location of the lesion and its radiological evolutionary stage. The average follow up was 14.8 months. The postoperative evaluation was based on the clinical and radiological scores of Hughston. Results Good clinical and radiological results in 97.5 and 95% of cases,respectively were obtained, with a significant correlation (P \ 0.001) between clinical scores and radiological Hughston scores. The closed nature of the growth plate during surgery has a significant deleterious effect (P \ 0.001) on the clinical and radiological score of Hughston. Conclusion All patients presenting juvenile condylar osteochondritis with open growth plate during treatment had good clinical and radiological results, confirming the validity and effectiveness of multiple transchondral drilling in this type of lesion.

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Section: Introductionmentioning

confidence: 99%

Juvenile osteochondritis of femoral condyles: Treatment with transchondral drilling. Analysis of 40 cases

Rammal

Phillipe

Schneider

et al. 2010

Journal of Children's Orthopaedics

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“…Because of the similarities between OCD in horses and humans, and the availability of equine tissue for analysis, pathophysiological studies of naturally occurring OCD in horses are therefore relevant to the further understanding of the disease in man. OCD occurs most commonly in the knees of adolescents and S. Luverty et al I Journal of' Ortlzopuedic Reseurch 20 (2002) 1282 1289 I283 young adults [31,33] and lesions are frequently observed on the trochleas of the femur, the site evaluated in this study, in young growing horses [24].…”

Section: Introductionmentioning

confidence: 99%

“…Although the exact pathogenesis of OCD remains to be elucidated, trauma, focally deficient blood supply, genetic, endocrinologic and nutritional factors have all been proposed as possible causes of OCD in humans [31,33,43,46] and horses [8,14,18,19,32,36,42].…”

Section: Introductionmentioning

confidence: 99%

Excessive degradation of type II collagen in articular cartilage in equine osteochondrosis

Laverty¹,

Okouneff²,

Ionescu³

et al. 2002

Journal Orthopaedic Research

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Articular osteochondrosis (OCD) occurs in both man and animals. The etiology remains to be determined. Studies of OCD lesions in animals may provide clues as to its pathogenesis. The aim of our study was to determine whether there was evidence for increased degradation namely proteoglycan (PG) release and type I1 collagen cleavage in articular cartilage harvested from O C D lesions. We examined ex vivo explants at post-mortem from equine OCD lesions and macroscopically normal site and age matched cartilage. These were cultured over a 10 day period in serum-free medium. Type I1 collagen cleavage was measured in articular cartilage and media using an Elisa assay to detect the coL2-3/4c,h,r, epitope, which is generated on cleavage of the triple helix of type I1 collagen by collagenases. PC release was measured by a dye-binding assay. Cumulative release of P C and COL2-3/4CShor, and their contents in cartilage at the end of the culture period were determined. In OCD lesions there was a significant increase in type I1 collagen cleavage by collagenase but no evidence for increase of PG degradation. These findings point to a selective increase in type 11 collagen cleavage by collagenases, in OCD lesions of the kind observed in osteoarthritis. Further work is needed to determine whether changes represent primary or secondary events in the pathogenesis of OCD.

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“…The difference between JOCD and adult OCD depends on skeletal maturity determined by whether the physis is closed. This categorisation is useful because JOCD has shown more spontaneous healing with conservative treatment than adult OCD [3][4][5][6][7]. In addition, the stability of the OCD is important, because stable fragments more frequently respond to conservative therapy [8,9].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, the stability of the OCD is important, because stable fragments more frequently respond to conservative therapy [8,9]. When JOCD is properly categorised, non-weight-bearing and immobilisation for six weeks followed by activity modification has reportedly led to successful healing by three to 12 months in up to 90 % of cases [2,4,6,10]. However, patients failing to heal after conservative treatment require surgical interventions resulting in a long drawn out healing process.…”

Section: Introductionmentioning

confidence: 99%

Osteochondral autograft transplantation for juvenile osteochondritis dissecans of the knee: a series of twelve cases

Sasaki

Matsumoto

Matsushita

et al. 2012

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to evaluate the clinical outcomes of osteochondral autograft transplantation (OAT) for juvenile osteochondritis dissecans (JOCD) lesions of the knee, especially time to return to sports. Methods Twelve knee JOCD lesions with OCD grade 3 and 4 categorised by magnetic resonance imaging (MRI) were treated with OAT. Nine male and two female skeletally immature patients averaging 13.7 years old were included. The OCD lesions were assessed arthroscopically and then fixed in situ using multiple osteochondral plugs harvested under fluoroscopy from the distal femoral condyle without damaging the physis. International Cartilage Repair Society (ICRS) score and Lysholm score were assessed pre-and postoperatively.Results After a mean follow-up of 26.2±15.1 months, the International Knee Documentation Committee (IKDC) subjective score significantly improved (p<0.01). According to the IKDC score, objective assessment showed that ten of 12 (83 %) had excellent results (score: A) after OAT and significantly improved (p<0.01). Based on ICRS criteria, results were satisfactory in all patients. No patients experienced complications at the graft harvest site. All patients returned to their previous level of athletic activity at an average of 5.7 months after the surgery. Conclusions OAT for JOCD of the knee provided satisfactory results in all patients at a mean follow-up of 26.2 months.

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Osteochondrosis Dissecans

Cited by 160 publications

References 0 publications

Juvenile osteochondritis of femoral condyles: Treatment with transchondral drilling. Analysis of 40 cases

Juvenile osteochondritis of femoral condyles: Treatment with transchondral drilling. Analysis of 40 cases

Excessive degradation of type II collagen in articular cartilage in equine osteochondrosis

Osteochondral autograft transplantation for juvenile osteochondritis dissecans of the knee: a series of twelve cases

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