Knee MRI – Axial cut showing the osteochondral defect of the patella. Osteochondral defects in the knee are due to lesions of the cartilage and bone. A Study of 5233 Knee Arthroscopies. An osteochondral defect, also commonly known as osteochondritis dissecans, of the knee refers to a damage or injury to the smooth articular cartilage surrounding the knee joint and the bone underneath the cartilage. 39. Am J Sports Med. 1 The knee joint is perhaps one of the busiest joints in the body as it bears most of the body weight when standing. Introduction . Paediatric. Stanford is currently … The “classical” defect involves a disruption of both the bone (osteo) and cartilage (chondral) .They usually occur on the Talus if effecting the ankle joint and are a region where the cartilage and underlying bone have been disrupted. This allows us to treat the bone defect without affecting the cartilage. 85(2):223-30. . Clinical Pearls. Fragmentation of a small focus of subchondral bone creates a defect between the … Freitag, J., Shah, K., Wickham, J., Boyd, R., & Tenen, A. - Articular cartilage defects: study of 25,124 knee arthroscopies - Articular cartilage lesions in 993 consecutive knee arthroscopies - Exam: Orthopaedics (1999), pp. 595-600. Autologous osteochondral graft provides good or excellent results in 85% of patients with focal contained chondral and osteochondral defects of the knee. tilage defects in the knee. Trochelar Groove Osteochondritis Dissecans of the Knee Patellofemoral Joint. Regardless of etiology, osteochondritis dissecans is an idiopathic focal joint disorder affecting the subchondral bone. Chondral and osteochondral defects in the PF compartment are often encountered in clinical practice on advanced imaging studies and/or during arthroscopy. Osteochondritis dissecans is an idiopathic disease which affects the subchondral bone and its overlying articular cartilage due to loss of blood flow. The Healing Potential of Stable Juvenile Osteochondritis Dissecans Knee Lesions. The effect of autologous adipose derived mesenchymal stem cell therapy in the treatment of a large osteochondral defect of the knee following unsuccessful surgical intervention of osteochondritis dissecans – a case study. Comment in Knee Surg Sports Traumatol Arthrosc. Osteochondritis dissecans (OCD or OD) is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone. Osteochondritis dissecans (OCD) of the knee is a well-described condition that can cause significant morbidity in children and adolescents; timely diagnosis is key to preventing compromise to the articular cartilage and maximizing opportunity to perform a restorative procedure. Codes. Treatment strategies in osteochondral defects of the talar dome: a systematic review. Osteochondral defects (OCDs) are very localised areas of joint damage which can occur in a number of different joints , not just the ankle. Patients and methods In 13 patients with a symptomatic articular cartilage defect, … Large osteochondral defects involving the femoral condyles of the knee have frustrated orthopaedic surgeons for generations. A major symptom of this condition is severe knee pain. Magnetic resonance imaging plays an important role in its early diagnosis, and early treatment can prevent damage to the articular cartilage as well as decrease the dislocation rate. If there is damage to the articulating structures of the knee, you will know it. Common entities include acute traumatic osteochondral injuries, subchondral insufficiency fracture, so-called spontaneous osteonecrosis of the knee, avascular necrosis, osteochondritis dissecans, and localized osteochondral abnormalities in osteoarthritis. Image courtesy of John Kiel, DO. Dec 2008;90(12):2655-2664; Wall EJ, et al. Of these, 37.5% were in the patella alone . Limited outcome data are available on osteochondral allografts in the pediatric and adolescent patient populations. Osteochondritis dissecans: a diagnosis not to miss. He denies fevers or mechanical knee symptoms. Its high resolution and excellent soft-tissue contrast allow for complete evaluation of both osseous and soft-tissue structures … The pediatric population is more susceptible to OC fractures because the calcified cartilage layer is incompletely formed, which results in a weakened interface between the articular cartilage and subchondral bone. 2006;273–293. Arthroscopy, 9 … Osteochondral defect; 14 public playlist includes this case . New procedures, technologies and improved assessment tools seek to address these injuries, which can cause significant disability, particularly in the young healthy patient. Any lesion larger than 500 mm² is prone to poor clinical outcome. In pediatric patients, the knee is the most common joint to be assessed with magnetic resonance (MR) imaging. Acute traumatic and sports-related osteochondral (OC) injuries occur in a variety of settings in the pediatric knee. ICD9. An osteochondral defect can occur acutely or develop as a result of several chronic conditions including (a) separation of the osteochondral fragment caused by an acute traumatic injury or as the end result of an unstable fragment in osteochondritis dissecans (OCD), (b) acute osteochondral impaction of the bone with resultant contour deformity, and (c) a collapse of the subchondral bone in a … Should the cartilage be disrupted, then microdrilling or micropicking of the … J Pediatr Orthop. The … BMC Musculoskeletal Disorders, 18(1), 298. MSK Trauma; GK - MSK - Knee; Knee; MSK - Beginner; Pediatric Cases... Dr Tarek … An acute knee injury resulting from patellar instability episodes, forced hyperextension, or direct blows to the knee may occasionally lead to the generation of osteochondral fragments originating from the patella, trochlea, or femoral condyle. It is made up of bones, … A chondral defect refers to a focal area of damage to the articular cartilage (the cartilage that lines the end of the bones). His exam is completely normal and symmetric to his left knee. 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. This is because when standing or walking, the force of … Prevalance and Outcome of Treatment. The medial constraint of the patella that prevents lateral subluxation, the medial patellofemoral ligament (MFPL), is torn. (OBQ09.101) A 10-year-old boy has atraumatic, progressive right knee pain for 2 months. Patients with stable lesions require a break … osteochondral defects of the knee. Peterson L, Minas T, Brittberg M, Lindahl A. M. Marcacci, E. Kon, S. Zaffagnini, et al.Use of autologous grafts for reconstruction of osteochondral defects of the knee. 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