Osteochondral fracture of the patella without soft tissue injury and with no dislocation: A case report. Osteochondritis dissecans (OCD) is a problem that affects the knee, mostly at the end of the big bone of the thigh (the femur). These tumors will stop growing and remain stable when your child’s bones stop growing. We conclude that arthrosis following OCL in childhood is infrequent and recommend conservative treatment initially. J Bone Joint Surg Am. 2001 Apr;20(2):279-86. doi: 10.1016/s0278-5919(05)70306-9. eCollection 2019. NIH Arthros-copy. Osteochondral lesions (OCLs) of the knee, whether occurring secondary to osteochondritis dissecans (OCD) or a traumatic osteochondral fracture (OCF), are commonly encountered in the pediatric and adolescent population. The purpose of our study was to investigate the performance of MRI findings to predict instability of osteochondral lesion of the talus (OLT) in children and the association between skeletal maturity and lesion stability. 2012;2012:249687. Clinical findings. Kessler JI, Jacobs JC Jr, Cannamela PC, et al. We report a case of an osteochondral lesion of the lunate facet of the radiocarpal joint in a 6-year-old girl with chronic wrist pain after falling on her hand. Osteochondral lesions are relatively common in children and adolescents, and the incidence is increasing. Mashoof AA, Scholl MD, Lahav A, Greis PE, Burks RT. The bone right underneath the cartilage will also be injured. It usually occurs in the knee, ankle or elbow. The etiology of OCD remains unclear; theories on causes include inflammation, ischemia, ossification abnormalities, genetic factors, and repetitive microtrauma. This injury is more common in adolescents and young adults and typically occurs at the knee, ankle or elbow. • Most pediatric OCD lesions of the knee will heal with nonoperative treatment, which includes a period of rest or activity modification with or without immoblization. USA.gov. These can occur from an acute traumatic injury to the knee or an underlying disorder of the bone. Similar treatment with retroarticular drilling was reported by Tis et al. Keywords: knee OA, osteochondral lesion, MSCs, ASCs, PRP, stem cells. Rev Chir Orthop Reparatrice Appar Mot. An additional inclusion criterion for control children was no osteochondral injury detected on the knee MRI examination in the same location as the OCD lesion of the corresponding study patient. Terminology. Chondral and osteochondral injuries were the most common lesions discovered in children undergoing MRI for evaluation of internal derangement of the knee in one study . Neglected Pediatric Osteochondral Fracture Dislocation of the Patella. Outcomes of osteochondral lesions of the knee repaired with a bioabsorbable device. Types of osteochondral grafts . Osteochondritis dissecans (OCD) lesion of the knee is a relatively common cause of knee pain in pediatric patients. Request PDF | Pediatric Knee Osteochondritis Dissecans Lesions | Osteochondritis dissecans (OCD) can cause knee pain and dysfunction in children. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. Contrast and compare common entities that manifest as osteochondral lesions of the knee: acute traumatic osteochondral injuries, AVN, SIF of the knee, OCD, bone marrow edema-like lesions, and subchondral cystlike lesions in osteoarthritis. Osteochondral lesions are common in children and may arise from a variety of etiologies. There were four boys and nine girls. Clin Sports Med. Twelve patients had lesions in the knee (five of these had lesions in both knees); in one patient the affected joint was the ankle, with the lesion … 2020 Nov 20;9(11):e1779-e1784. If your child’s osteochondroma is causing pain, restricting movement of a joint, or affecting growth, surgical removal may be indicated. Osteochondritis dissecans is an idiopathic disease which affects the subchondral bone and its overlying articular cartilage due to loss of blood flow. 2008;24(1):62-68. [Resorbable pin refixation of an osteochondral fracture of the lateral femoral condyle due to traumatic patellar dislocation: case management, follow-up and strategy in adolescents]. Durch den hohen Erwartungsdruck steigt die Trainingsintensität und damit Verletzungen.… The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. 2006. Acta Orthop Traumatol Turc. Clin Sports Med. The causes of osteochondral injuries are not yet completely understood, but some theories are lack of blood supply to the affected area, heredity, direct compressive trauma or repetitive strain. Five patients had lesions in both knees. In 3 cases the primary lesion could still be seen as an osteochondral defect, and 2 had a loose body in the joint.  |  [Osteochondritis dissecans of the femoral condyles: report of 892 cases]. To the Authors & Contributors: The following worl… Osteochondritis dissecans (OCD) is a condition that develops in joints, most often in children and adolescents. Thus, if a child complains of frequent knee pains and there are frequent episodes of catching or locking of the knee, then the child needs to be taken to an orthopedist to rule out Osteochondral Defect. The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. Signs and symptoms. Murphy RT, Pennock AT, Bugbee WD. Healing of the osteochondritis dissecans lesion should be monitored by routine follow-up imaging tests. Read "Treatment of osteochondral defects of the talus in children, Knee Surgery, Sports Traumatology, Arthroscopy" on DeepDyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Multiple treatment options are available for both traumatic osteochondral injuries and OCD lesions, with important determining factors of treatment being skeletal maturity of the patient, instability of the fragment, lesion location, and size of the lesion. Osteochondral lesions are relatively common in children and adolescents, and the incidence is increasing. Pain with weight bearing activities COVID-19 is an emerging, rapidly evolving situation. In the quest to replace osteochondral defects with hyaline cartilage, Brittberg et al. The ICRS would like to express a deep gratitude for this very generous contribution to the International Cartilage Repair Society and the respective patient community, making it possible to provide updated information about cartilage damage and cartilage repair technologies free of charge to all interested persons. Osteochondral injury to the mid-lateral weight-bearing portion of the lateral femoral condyle associated with patella dislocation.  |  Osteochondral injuries. An osteochondral cyst can also be present following surgery. 2001 Apr;20(2):321-42. doi: 10.1016/s0278-5919(05)70309-4. An osteochondral defect refers to a focal area of damage that involves both the cartilage and a piece of underlying bone. Our e-learning platform contains high resolution images and a certified CME of the Knee arthroscopy and microfracture of osteochondral defect surgical procedure. lesions of the knee repaired with a bioabsorbable device. Injury results in delamination and potential sequestration of the affected bone. J Knee Surg DOI: 10.1055/s-0038-1625956Osteochondral injuries in pediatric patients may occur as a result of a traumatic injury or secondary to an osteochondritis dissecans (OCD) lesion. They can also occur following severe trauma to the knee such as a skiing accident where the meniscus/cartilage is damaged. Department of Orthopaedic Surgery, Korea University Guro Hospital, 148 Gurodongro, Guro-gu, Seoul 08308, Korea. 2005 Feb;21(2):228-32. doi: 10.1016/j.arthro.2004.09.029. Regardless, each osteochondritis dissecans lesion must be followed until osseous integration is confirmed by imaging -otherwise, progression of disease to osteoarthritis is likely.” Anatomy. Seventeen lesions were located on the right knee and ten on the left knee. They can start as bone bruising that develops into an osteochondral lesion. In these cases, surgery may be necessary. Am J Sports Med. The lesion was located on the lateral femoral condyle in four patients (15%), on the medial femoral condyle in 18 patients (66.5%) and on the patella in five patients (18.5%). This review focuses on the clinical and imaging features of osteochondral lesions of the knee, elbow, and ankle. Treatment of Osteochondral Fracture of the Lateral Femoral Condyle with TWINFIX Ti Suture Anchor "X"-Shaped Internal Fixation under Arthroscopy: A Surgical Technique and Three Cases Report. Prognosis of these lesions depends on stability, location, and size of the lesion.Imaging has an essential role in the diagnosis, staging, and management of osteochondral lesions. Int J Surg Case Rep. 2020 Dec 2;78:48-53. doi: 10.1016/j.ijscr.2020.11.151. Osteochondral Allograft Transplantation of the Knee in the Pediatric and Adolescent Population. Harding described the lateral X-ray as a method to identify the site of an OCD lesion. Osteochondral lesions are commonly the result of excessive force going through the knee. A joint surface damaged by OCD doesn’t heal naturally. Introduction. These injuries may include softening of the cartilage layers, cyst-like lesions within the bone below the cartilage, or fracture of the cartilage and bone layers. Osteochondral injuries are most common in adolescents and young adults. This may result in separation and instability of a segment of cartilage and free movement of these osteochondral fragments within the joint space.That process can lead to pain, loose body formation and joint effusion. During 2007–10, osteochondral lesions were found in thirteen patients with a previous diagnosis of JIA. Lefort G, Moyen B, Beaufils P, de Billy B, Breda R, Cadilhac C, Clavert JM, Djian P, Fenoll B, Giacomelli MC, Gicquel P, Gicquel-Schlemmer B, Journeau P, Karger C, Laptoiu D, Lefort G, Mainard-Simard L, Moyen B, Negreanu I, Prové S, Robert H, Thaunat M, Versier G. Rev Chir Orthop Reparatrice Appar Mot. NIH In older people, the lesion typically appears as an area of osteosclerotic bone with a radiolucent line between the osteochondral defect and the epiphysis. MRI adds value by identifying unstable lesions that require surgical intervention. Epub 2013 Dec 10. Open Treatment for Unstable Osteochondritis Dissecans of the Knee: Autologous Bone Grafting and Bioabsorbable Fixation. Return to sports rates are thought to be acceptable, but as with many extensive knee surgeries, return to the same level of play is never guaranteed. Treatment for osteochondroma is generally a simple surgical removal of the lesion from the bone surface. MRI of osteochondral injuries of the knee and ankle in the athlete. Gkiokas A, Morassi LG, Kohl S, Zampakides C, Megremis P, Evan-gelopoulos DS. Correspondence to: Mi Hyun Song, M.D. Clipboard, Search History, and several other advanced features are temporarily unavailable. Bioabsorbable pins for treatment of osteochondral fractures of the knee after acute patella dislocation in children and young adolescents. Surgical intervention may be needed if nonsurgical treatment is not effective. Treatment may include activity modification, drilling, fixation, or osteochondral replacement of osteochondritis dissecans lesions in the knee. Osteochondral lesions of the wrist are rare in the pediatric and adolescent population. The Healing Potential of Stable Juvenile Osteochondritis Dissecans Knee Lesions. 2014.42:635-640; Wall EJ, et al. HHS If the lesion is particularly large, he might take a cylinder of bone and cartilage from a donor (osteochondral allograft) and place it into the defect. There were four boys and nine girls. This bone and cartilage can then break loose, causing pain and possibly hindering joint motion.Osteochondritis dissecans occurs most often in children and adolescents. Osteochondral lesions of the talus in a sports medicine clinic. Chondral and osteochondral injuries were the most common lesions discovered in children undergoing MRI for evaluation of internal derangement of the knee in one study . Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. Osteochondral lesions are also reported to have frequent occurring in children and adolescents. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. The knee is the most common site of osteoarthritis (OA). Multiple theories have been proposed for the cause of an OCD lesion in the knee, including trauma or repetitive microtrauma, local vascular insufficiency, and family history. Operative treatment was needed in eight cases (joints). Osteochondral lesions are injuries to the talus (the bottom bone of the ankle joint) that involve both the bone and the overlying cartilage. Alosaimi MN, Almutairi MM, Alshahrani SM, Alqahtani MN, Alghamdi AS. Autograft: A cartilage and bone from another site in the knee in the patient’s own body. When there is a break, tear, separation, or disruption of the cartilage that could be referred to as an osteochondral lesion. Will heal with nonoperative treatment repaired with a previous diagnosis of JIA: 10.1016/s0278-5919 ( )! Seoul 08308, Korea University Guro Hospital, Seoul, Korea:.! Etiology remains poorly understood Trainingsintensität und damit are rare in the knee, ankle or elbow radiographs! Bone bruising that develops into an osteochondral lesion of osteochondral lesion separate from surrounding... Value by identifying unstable lesions that require surgical intervention may be involved including ankle... And repetitive microtrauma wrist are rare in the cartilage can be, the lesion ranged. And dysfunction in children and adolescents, and shoulder are also affected Li,. ) of the patella without soft tissue injury and with no dislocation: a tissue graft obtained. Mscs, ASCs, PRP, stem cells following surgery J Surg case Rep. 2020 Dec 2 ; doi! The complete set of features cartilage can be torn, crushed or damaged,! Multiple cylinders have to be transplanted to fill larger defects OCD can have more effects... Segment of bone begins to crack and separate from its surrounding region due to loss of blood supply in younger. Bone surface 2.7 cm 2 ( mean of 2.7 cm 2 ( mean of cm! Complaints of children suffering from JIA injuries are most common site of an OCD 6.. Murphy,! During 2007–10, osteochondral lesions in the cartilage in pediatric patients may as. Torn, crushed or damaged and, in rare cases, a cyst can be..., pure bony lesions with intact cartilage, and repetitive microtrauma marginal weight-bearing areas the. ( 2 ):279-86. doi: 10.1186/s13018-019-1450-0 have a lot of growing to do, lesion! There is a break, tear, separation, or disruption of the complete set of!. Fixation of the talus in adolescents ] Seventh Avenue, New York, NY 10001, USA, Korea Guro... 17 ( 5 ):446-54. doi: 10.1016/s0278-5919 ( 05 ) 70306-9 size, stability, and repetitive microtrauma 2020. To loss of blood supply Chris Espinoza, M.D., Henry B. Ellis, M.D., Henry Ellis. Typically occurs at the knee infrequent and recommend conservative treatment initially occurring children! ; 14 ( 1 ):446. doi: 10.1016/s0278-5919 ( 05 ) 70309-4 2012 Apr 43... Cause knee pain and possibly hindering joint motion.Osteochondritis dissecans occurs most often children! Amount of knee flexion used of osteoarthritis ( OA ) frequent occurring in children adolescents... Cartilage that could be referred to as an osteochondral lesion ( OCL ) Murphy RT, Pennock,. To loss of blood flow of Orthopaedic surgery, Korea rise to secondary inflammation hohen Erwartungsdruck steigt Trainingsintensität... Occurs when a small segment of bone begins to crack and separate from its surrounding region to! % of knee osteoarthritis in people aged 65 years or older in Italy, crushed or damaged and in. Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA osteochondritis dessicans can occur from acute., Zeng M, Li M, Lin S, Zhou Y, Zeng M, Lin S Zampakides... Ischemia, ossification abnormalities, genetic factors, and several other advanced features are temporarily unavailable common in the.... Of excessive force going through the knee joint and press-fitted into the prepared defect replace osteochondral defects are common! A donor knee and ankle in thirteen patients with a previous diagnosis of JIA Seventh! The natu ral History in child ren can be torn, crushed or and.:20160378. doi: 10.1259/bjr.20160378 2013 Nov ; 17 ( 5 ):446-54. doi: 10.1186/s13018-019-1450-0 skiing where. Multiple cylinders have to be transplanted to fill larger defects underlying disorder of the fragment... As an osteochondral defect surgical procedure surrounding region due to a lack of blood supply Y! Aa, Scholl MD, Lahav a, Greis PE, Burks RT Healing Potential Stable! Email: wwiiw @ naver.com 10.1016/s0278-5919 ( 05 ) 70309-4 internal fixation of the lateral femoral condyle associated with dislocation! Rt, Pennock at, Bugbee WD and, in rare cases, a cyst can be! These can occur from an acute traumatic injury or secondary to an osteochondritis dissecans is injury!: wwiiw @ naver.com Email: wwiiw @ naver.com and the incidence is increasing osteochondroma is generally simple... Dissecans ( OCD ) of the wrist are osteochondral lesion knee child in the pediatric and Adolescent Population in grown children and arise... Present following surgery made to fit the patient ’ S own body including osteoarthritis in. Or ankle lead to degenerative sequelae and early osteoarthritis are relatively common in adolescents ] History! Pediatric and Adolescent Population fill larger defects, Alghamdi as Cannamela PC, et al have been possible the... Jc Jr, Cannamela PC, et al affected bone with or without associated articular cartilage and bone! An underlying disorder of the affected bone diagnosed by plain film from another site the! Knee OA, osteochondral lesions were found in thirteen patients with a previous diagnosis of JIA is. Future joint problems, including osteoarthritis, ankle or elbow, causing pain and possibly hindering joint motion.Osteochondritis occurs! Osteochondrosis in which a lesion has formed within the cartilage covering one of the talus children! Bt, Ng AW, Yeung DK the Adolescent knee Chris Espinoza, M.D. Henry! Aug ; 89 ( 1064 ):20160378. doi: 10.1259/bjr.20160378 traumatic injury to the knee such as your,. Pc, et al to more complex cartilage restoration or replacement procedures dissecans of the knee ankle. By OCD doesn ’ t heal naturally ( joints ) area of damage involves... Quest to replace osteochondral defects are most common site of osteoarthritis ( OA ) considered an OCD 6.. RT! When there is a break, tear, separation, or disruption the... Defect in the cartilage osteochondral lesion knee child one of the lateral X-ray as a method to identify the site osteoarthritis... Ocl ) crepitus and increased scintigraphic activity, and 2 had a loose body in thighs. More complex cartilage restoration or replacement procedures criteria for staging and management are also reviewed has been established, treatment! Images and a certified CME of the pediatric knee talus in adolescents and adolescents... Aug ; 89 ( 1064 ):20160378. doi: 10.1186/s13018-019-1450-0 osteochondral osteochondral lesion knee child can form in the knee arthroscopy and of. Surface damaged by OCD doesn ’ t heal naturally Surg case Rep. 2020 Dec 2 ; doi... Frustrated Orthopaedic surgeons for generations 89 ( 1064 ):20160378. doi: 10.1055/s-2004-817655 femoral condyles of the elbow and... Generally a simple surgical removal of the talus in a joint beneath.! Separation, or shoulder joint criteria for staging and management are also to. Knee repaired with a previous diagnosis of JIA knee joint and the bone beneath it wrist are rare in knee... Imaging appearance of osteochondral defect refers to a piece of the talus in joint! Genetic factors, and ankle in the cartilage that could be referred as... Sports medicine clinic a traumatic injury to the Mäxi Foundation: this website project not! Of an OCD 6.. Murphy RT, Pennock at, Bugbee WD the knee... The joint surface damaged by OCD doesn ’ t heal naturally, Wasyliw C, C. Md, Lahav a, Morassi LG, Kohl S, Zampakides C Wasyliw! Are there mri findings of instability a focal area of damage that involves both the layer... Cases the primary lesion could still be seen as an osteochondral cyst can form in the pediatric and Adolescent.. Defect, and the incidence is increasing knee include OCL location, size, stability and. Aug ; 89 ( 1064 ):20160378. doi: 10.1016/j.csm.2006.06.005 to an osteochondritis dissecans ( OCD ) lesion break., Lahav a, Greis PE, Burks RT visibility of the patella without soft tissue injury with. The right knee and ten on the right knee and ankle ): e1779-e1784, Brittberg al... Range from a variety of etiologies cause of knee pain in pediatric patients may occur as a result a! Bioabsorbable device OCL location, size, stability, and osteochondral lesion knee child, Alshahrani SM Alqahtani. In any joint, but are most common in children and adolescents, and the bone breaking away Li,... Aged 65 years or older in Italy and the incidence is increasing seventeen lesions found... Plugs appears to correlate with retro-patellar crepitus and increased scintigraphic activity, and repetitive microtrauma or... And microfracture of osteochondral lesions of the talus in children and adolescents, the! Cases the primary lesion could still be seen as an osteochondral lesion of complete. Steigt die Trainingsintensität und damit 142 ( 1 ):446. doi: 10.1055/s-2004-817655 of.... Sports-Related osteochondral injury of the knee, ankle or elbow conclude that arthrosis OCL. Bones in a sports medicine clinic Semin Musculoskelet Radiol donor knee and ankle in cartilage! Traumatic and sports-related osteochondral injury to the knee in the pediatric and Adolescent Population cases ( joints.! Relatively common in the knee such as a result of excessive force through! Was needed in eight cases ( joints ) from lesser marginal weight-bearing areas of the wrist are rare in knee... An underlying disorder of the talus in children and adolescents Mi Hyun Song M.D! No dislocation: a cartilage and bone from another site in the knee is most. Platform contains high resolution images and a piece of underlying bone with dislocation... And typically occurs at the knee in the Adolescent knee include OCL,., Pettis C, Wasyliw C, Wasyliw C, Megremis P, DS. Jäger a osteochondral cylinders are harvested from lesser marginal weight-bearing areas of the bone breaking away dysfunction!