Osteochondritis Dissecans Lesions of the Knee: Evidence-Based Treatment

被引:0
作者
Nammour, Michael A. [1 ]
Mauro, Craig S. [2 ]
Bradley, James P. [2 ]
Arner, Justin W. [2 ]
机构
[1] Louisiana State Univ, Dept Orthopaed Surg, Hlth Sci Ctr Shreveport, Shreveport, LA USA
[2] Univ Pittsburgh, Dept Orthopaed Surg, Med Ctr, Pittsburgh, PA 15260 USA
关键词
JOCD; CLASSIFICATION; MULTICENTER; MANAGEMENT;
D O I
10.5435/JAAOS-D-23-00494
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Osteochondritis dissecans (OCD) of the knee is a potentially disabling condition in adolescent and young adults, which is likely multifactorial in origin. In recent years, there have been notable improvements in identification and treatment. Clinical presentation varies based mostly on OCD lesion stability. Patients with stable lesions generally present with vague knee pain and altered gait while mechanical symptoms and effusion are more common with unstable lesions. Lesions most commonly occur on the lateral aspect of the medial femoral condyle in patients aged 10 to 20 years. Magnetic resonance imaging is vital to diagnose and predict clinical treatment, which is largely based on stability of the fragment. Conservative treatment of stable lesions in patients with open physis is recommended with protected weight-bearing and gradual progression of activities over the course of 3 to 6 months. Stable OCD lesions which failed a nonsurgical course can be treated with transarticular or retrograde drilling while unstable lesions usually require fixation, autologous chondrocyte implantation (ACI), osteochondral autograft transfer (OATS), or osteochondral allograft transplantation. This review highlights the most current understanding of knee OCD lesions and treatment options with the goal of optimizing outcomes in this difficult pathology.
引用
收藏
页码:587 / 596
页数:10
相关论文
共 40 条
  • [1] Surgical management of osteochondritis dissecans of the knee in the paediatric population: a systematic review addressing surgical techniques
    Abouassaly, M.
    Peterson, D.
    Salci, L.
    Farrokhyar, F.
    D'Souza, J.
    Bhandari, M.
    Ayeni, O. R.
    [J]. KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 2014, 22 (06) : 1216 - 1224
  • [2] Functional and Radiographic Outcome of Stable Juvenile Osteochondritis Dissecans of the Knee Treated With Retroarticular Drilling Without Bone Grafting
    Adachi, Nobuo
    Deie, Masataka
    Nakamae, Atsuo
    Ishikawa, Masakazu
    Motoyama, Mitsuru
    Ochi, Mitsuo
    [J]. ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 2009, 25 (02) : 145 - 152
  • [3] Osteochondritis Dissecans of the Knee-Conservative Treatment Strategies: A Systematic Review
    Andriolo, Luca
    Candrian, Christian
    Papio, Tiziana
    Cavicchioli, Alessia
    Perdisa, Francesco
    Filardo, Giuseppe
    [J]. CARTILAGE, 2019, 10 (03) : 267 - 277
  • [4] Osteochondritis Dissecans of the Knee: Etiology and Pathogenetic Mechanisms. A Systematic Review
    Andriolo, Luca
    Crawford, Dennis C.
    Reale, Davide
    Zaffagnini, Stefano
    Candrian, Christian
    Cavicchioli, Alessia
    Filardo, Giuseppe
    [J]. CARTILAGE, 2020, 11 (03) : 273 - 290
  • [5] Osteochondral Injuries of the Knee in Pediatric Patients
    Bauer, Kathryn L.
    [J]. JOURNAL OF KNEE SURGERY, 2018, 31 (05) : 382 - 391
  • [6] Osteochondritis Dissecans: Etiology, Pathology, and Imaging with a Special Focus on the Knee Joint
    Bruns, Juergen
    Werner, Mathias
    Habermann, Christian
    [J]. CARTILAGE, 2018, 9 (04) : 346 - 362
  • [7] The three critical components in the conservative treatment of juvenile osteochondritis dissecans (JOCD) - Physician, parent, and child
    Cahill, BR
    Ahten, SM
    [J]. CLINICS IN SPORTS MEDICINE, 2001, 20 (02) : 287 - +
  • [8] OSTEOCHONDRITIS DISSECANS - QUESTION OF ETIOLOGY
    CAMPBELL, CJ
    RANAWAT, CS
    [J]. JOURNAL OF TRAUMA, 1966, 6 (02): : 201 - &
  • [9] Autologous Chondrocyte Implantation as Treatment for Unsalvageable Osteochondritis Dissecans: 10-to 25-Year Follow-up
    Carey, James L.
    Shea, Kevin G.
    Lindahl, Anders
    Vasiliadis, Haris S.
    Lindahl, Carl
    Peterson, Lars
    [J]. AMERICAN JOURNAL OF SPORTS MEDICINE, 2020, 48 (05) : 1134 - 1140
  • [10] Novel Arthroscopic Classification of Osteochondritis Dissecans of the Knee: A Multicenter Reliability Study
    Carey, James L.
    Wall, Eric J.
    Grimm, Nathan L.
    Ganley, Theodore J.
    Edmonds, Eric W.
    Anderson, Allen F.
    Polousky, John
    Murnaghan, M. Lucas
    Nissen, Carl W.
    Weiss, Jennifer
    Lyon, Roger M.
    Chambers, Henry G.
    [J]. AMERICAN JOURNAL OF SPORTS MEDICINE, 2016, 44 (07) : 1694 - 1698