Edema is present in the bed of the defect (asterisk). 8. Thieme Publishing Group. The defect may be found on the femoral condyle, tibial plateau, patella, talus, humerus or on other articular surfaces. Cause of a “locking knee” Osteochondritis dissecans. Onset is between childhood and middle age, with the majority of patients being between 10 and 40 years of age, with approximately a 2:1 male to female ratio 3. 1A, 1B, and 1C), whereas in five (50%) of the 10 patients, the chondral defects were isolated to the midlateral weight-bearing portion of the lateral femoral condyle (Figs. The Athlete's Shoulder. As the process progresses, more pronounced contour abnormalities, fragmentation and density changes (both lucency and sclerosis) become evident. Tetyana Gorbachova, Yulia Melenevsky, Micah Cohen et-al. Sailors ME. 24 (4): 286-99. A chondral defect is a defect in the articular (hyaline) cartilage at the end of the bones. It was first described by the German surgeon Franz Konig in 1888. Bone and joint imaging. 14. 21 (2): 119-26. The defect was debrided down to the subchondral bone with an arthroscopic shaver and sized with the osteochondral autograft transplantation system, as shown in Fig. Recently established procedures like autologous chondrocyte implantation or matrix-associated chondrocyte implantation yield good results, but include the disadvantage of two-step procedures. For the same photo without the arrows, click here. The combined use of standard and newer magnetic resonance (MR) imaging techniques makes it possible to evaluate both the morphologic status and the biochemical contents of the repair tissue (,1–,9). It is often associated with intraarticular loose bodies. A significant number of osteochondral injuries involve the midlateral weight-bearing portion of the lateral femoral condyle and are more posterior than would be expected after transient dislocation of the patella. Blue arrow points to crescentric lucency in the convex surface of the medial condyle of the knee. This 26 year old man has right knee pain. When surgery is performed, the results in most cases are only "fair". 15. Osteochondritis dissecans of the knee: value of MR imaging in determining lesion stability and the presence of articular cartilage defects. A Consensus Statement. Epub 2017 Jun 22. W B Saunders Co. (2005) ISBN:0721602703. 1. The osteochondral defects involved the articular surface of the trochlear groove in three (30%) of the 10 patients (Figs. © Copyright Early findings include subtle flattening or indistinct radiolucency about the cortical surface. osteochondritis dissecans surgical staging, differential diagnosis of erosive arthritis, repetitive throwing / valgus stress and gymnastics / weight bearing on upper extremity, valgus stress / compressive force on the vulnerable  chondroepiphysis of the radiocapitellar joint in skeletally immature patients is supported as the aetiology for OCD of the capitellum, In the talus, 96% of lateral lesions and 62% of medial lesions were associated with direct trauma, family history: epiphyseal dysplasia has been postulated as a subset of OCD, femoral condyles are most common site accounting for ~95% of all cases:Â, variable signal overall with intermediate to low signal adjacent to fragment and variable fragment signal, the high signal line demarcating fragment from bone usually indicates an unstable lesion however false positives can result from oedema, low signal loose bodies, outlined by high signal fluid, donor defect filled with high signal fluid, enhancement indicates the viability of the lesion, high signal intensity rim at the interface between the fragment and the adjacent bone on T2-weighted MR image, high signal intensity line extending through the articular cartilage overlying the lesion, focal osteochondral defect filled with joint fluid, indicating complete detachment of the fragment, persistent pain with activity: ~ 2/3 following surgical management of knee and 40% following surgical management of elbow, normal irregular distal femoral epiphyseal ossification. Recognition and Treatment of Osteochondritis Dissecans of the Femoral Condyles. Osteochondral autograft transplantation surgery was initially conducted in small chondral defects of the knee but has been used in multiple other joints like the hip, ankle, shoulder and elbow in the meantime. 2 article feature images from this case 13 public playlist includes this case Osteochondral Defect is the name given to a condition most noticeable in the knee, in which a part of the bone and cartilage gets separated from the knee joint resulting in chronic pain in the knee and difficulties performing normal activities of daily living. 2008;32 (2): 217-21. 79 (11): 1653. A long-term follow-up study. 11. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. Treatment strategies in osteochondral defects of the talar dome: a systematic review. Steadman JR, Briggs KK, Rodrigo JJ et-al. Osteochondritis dissecans (OCD) : general. Osteochondral fracture of the lateral femoral condyle is a rare injury of the knee joint, which mostly occurs in adolescence 1.In adolescence, the cartilage‐bone interface is the weakest transitional area in the knee joint, and there is no obvious boundary between calcified and uncalcified cartilage 2.The biomechanical strength of immature osteochondral junction was lower … St Vincent's University Hospital Radiology Department 2020, Neuropathic joint – Charcot-Marie-Tooth disease, Avascular necrosis – subchondral collapse. Osteochondritis dissecans of the elbow. Resnick D, Kransdorf MJ. It is known from long-term followup studies, such as those conducted by Linden, 7 that osteochondritis dissecans diagnosed in adulthood is likely to lead to the development of early onset osteoarthritis. Autologous chondrocyte implantation segmental-sandwich technique. (1997) The Journal of Bone and Joint Surgery (american Volume). Osteochondral lesions are acquired, potentially reversible injuries of the subchondral bone with or without associated articular cartilage involvement. (2003) Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. The Plan operates in Massachusetts under the trade name Boston Medical Center HealthNet Plan and in other states under the trade name Well Sense Health Plan. (B) Preparation of the bone defect: a high-speed bur, usually 8 mm in diameter, removed all subchondral sclerotic bone back to … 3. ~50% (range 35-70%) of patients achieve a "good to excellent" clinical outcome 3 but even in these cases, the majority develop osteoarthritis. A modified MR imaging classification is suggested based on a combination of the appearances of such lesions at MR imaging and their short-term osteochondral sequelae. 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