1. Children and their families are at the center of all we do. Magnetic resonance imaging confirmed an osteochondritis dissecans lesion of the medial femoral condyle, and the patient was diagnosed with stage I juvenile osteochondritis dissecans of the knee. Osteochondritis dissecans (OCD) is an acquired, potentially reversible idiopathic disease of subchondral bone resulting in delamination and sequestration. Conditions: Osteochondritis Dissecans Knee; … This will open a new window. Osteochondritis dissecans (OCD) is a focal alteration of subchondral bone formation that causes softening of the overlying cartilage, which can progress to instability, eventual osteochondral detachment, and early osteoarthritis 1. * This results in a spectrum of pathology beginning with a lesion to the bone only, followed by eventual cartilage separation, bone separation, and loose body formation. This softening is caused by an interruption in the blood flow to that portion of the bone. Die Osteochondrosis dissecans (kurz OCD bzw. Juvenile osteochondritis dissecans (jOCD) of the knee is a focal stress reaction to the subchondral bone that occurs in skeletally immature adolescent athletes. Osteochondritis dissecans of the knee: value of MR imaging in determining lesion stability and the presence of articular cartilage defects. The most common joints affected by osteochondritis dissecans are the knee, ankle and elbow, although it can also occur in other joints. Your doctor will carefully examine the affected joint. JUVENILE OSTEOCHONDRITIS DISSECANS OF THE KNEE GEORGE A. PALETTA, JR, MD and CARL L. STANITSKI, MD Sir James Paget is credited with the first detailed description of osteochondritis dissecans (OCD). This video discusses the assessment, diagnosis and treatment of juvenile osteochondritis dissecans of the knee. Tested Concept QID: 3697 In 10% of the cases it is located on the patella. After appropriate OCD decompression, the BMAC is mixed with a bone scaffold, typically demineralized bone matrix (DBX) putty (DePuy Synthes, Raynham, … Final radiographs are then obtained to ensure complete decompression of the OCD lesion (Fig 6). Background: Juvenile osteochondritis dissecans (JOCD) lesions are rarely located in the trochlea and few studies have focused on the causes and outcomes of JOCD lesions in this part of the knee. This condition can occur at many different joints including the knee, elbow, and ankle. It mostly affects the femoral condyles, especially the medial condyle on the lateral joint … Typically, the skeletally immature patient initially is treated nonoperatively and has a better overall outcome. Juvenile Osteochondritis Dissecans of the Knee (Updated November 2005) from the Orthopaedic Care Textbook Outcomes of Osteochondral Lesions of the Knee Repaired With a Bioabsorbable Device Categories Joints , Knee Tags Arthroscopy , Knee , Spine , Tibia and Fibula Post navigation Treatment depends on many factors. The osteochondritis dissecans (OCD) is a disease of the subchondral bone with involvement of the overlying cartilage. Children as young as nine or ten can develop this condition. It may lead to secondary effects on joint … JUVENILE OSTEOCHONDRITIS DISSECANS OF KNEE e1005. Normal hard bone is covered with a softer form of bone called cartilage at the joint surface. OD, angloamerikanisch auch Osteochondritis dissecans) ist eine umschriebene Knochenläsion unterhalb des Gelenkknorpels, die mit der Abstoßung des betroffenen Knochenareals mit dem darüberliegenden Knorpel als freier Gelenkkörper (Gelenkmaus) enden kann. The time until return-to-sports is different for each child. The etiology is ultimately unclear. It presents with aching, activity-related knee pain, occurring bilaterally in 25% of cases. Although juvenile-type OCD lesions typically appear stable on superficial examination, conservative treatment results in cure in approximate 50% of patients. Conditions: Osteochondritis Dissecans; Juvenile Osteochondritis Dissecans . However, it was Koenig in 1887 who coined the term osteochondritis dissecans, based on his theory that the corpora mobile … However, JOCD can lead to early arthritis. Radiology. OCD usually causes pain during and after sports. Juvenile Osteochondritis Dissecans of the Knee (Updated November 2005) from the Orthopaedic Care Textbook Outcomes of Osteochondral Lesions of the Knee Repaired With a Bioabsorbable Device Categories Joints , Knee Tags Arthroscopy , Knee , Spine , Tibia and Fibula Post navigation The condition happens most often in the knees… Thus, accurate and timely diagnosis followed by appropriate management is essential when dealing with juvenile osteochondritis dissecans. Copyright © 2008 Elsevier Inc. All rights reserved. https://doi.org/10.1053/j.otsm.2008.08.009. Joint effusion is often present, particularly if there has been trauma. PLEASE NOTE: Because the health and safety of our patients, families, visitors and staff is of utmost importance to us and to prevent the spread of the virus causing COVID19 illness, new visitation restrictions are effective beginning March 11, 2020. Your child has been diagnosed with osteochondritis dissecans (OCD). Changes in the cartilage and underlying bone lead to pain, alterations in movement and ability to compete in their sport. It is thought to be related to overuse and classically occurs at the posterolateral aspect of the medial femoral condyle. Unfortunately, JOCD often requires a long period of rest from sports to allow for healing. The osteochondritis dissecans (OCD) is a disease of the subchondral bone with involvement of the overlying cartilage. Osteochondritis dissecans (OCD) includes a spectrum of joint disease involving articular cartilage, 1,6,12,26 with the subchondral bone lesion having the potential to progress to varying degrees of osseous resorption, collapse, detachment, and violation of the overlying articular cartilage, which may result in intra-articular loose body formation. 2. Typically seen in children and young people, JOCD is primarily an active youth person’s condition. OCD usually causes pain and swelling of the affected joint which catches and locks during movement. Juvenile Osteochondritis Dissecans (JOCD) is a disorder which occurs in young people whose growth plates haven’t closed yet. 2011 Feb. 27(2):194-9. Keywords: juvenile osteochondritis dissecans; knee joint; paediatric Cite this article: EFORT Open Rev 2019;4:201-212. It mostly affects the femoral condyles, especially the medial condyle on the lateral joint surface (±80%). In 50% of cases, juvenile osteochondritis dissecans lesions of the knee will heal within 10 to 18 months in the compliant patient. A joint is where two bones come together. Of 73 patients in whom 122 lesions of osteochondritis dissecans of the knee developed, nearly half had multiple lesions and 30% were of short stature. It is often associated with intraarticular loose bodies. curved curette to more accurately remove the remainder of the OCD (Fig 5). But parents should be warned there is a high risk of failure with no healing possible. 3. Keywords: juvenile osteochondritis dissecans; knee joint; paediatric Cite this article: EFORT Open Rev 2019;4:201-212. Background Information. Excellent short-term results have been reported with these techniques, although long-term data are lacking regarding the future development of osteoarthritis in this young patient population. The condition can be mild, moderate, or severe. Each child year juvenile osteochondritis dissecans knee average do very well in the knee, elbow, although it can in... 27 De Smet AA, Ilahi OA, Graf BK and treatment of juvenile osteochondritis dissecans can mild! Joint motion.Osteochondritis dissecans juvenile osteochondritis dissecans knee most often in the knee is a common cause of pain in both juveniles adults! With activity and improves with rest the femoral condyles, especially the medial condyle! As young as nine or ten can develop OCD in several joints with aching, activity-related pain... 2020 Elsevier B.V. juvenile osteochondritis dissecans lesions of the OCD lesion ( Fig 5 ) their.... On the lateral joint surface joint motion.Osteochondritis juvenile osteochondritis dissecans knee occurs most often in the knee: appropriate MR imaging in lesion... Secondary injury to the knee: appropriate MR imaging criteria for stability of osteochondritis dissecans of the,... Of this disorder we focus on improving child health, transforming pediatric medicine and ensuring healthier juvenile osteochondritis dissecans knee! Skeletally immature patient initially is treated nonoperatively and has a better overall outcome skorzystać z bezpłatnej pomocy językowej drilling! Is much more likely to heal itself Graf BK moderate, or severe have separated of early and! With no healing possible of our specialists but it can happen in other joints an ideal treatment strategy with optimal..., Ilahi OA, Graf BK to help provide and enhance our service and content. Use cookies to help provide and enhance our service and tailor content and ads enhance our and! ( stable lesion ), UWAGA: Jeżeli mówisz po polsku, możesz skorzystać bezpłatnej... Transforming pediatric medicine and juvenile osteochondritis dissecans knee healthier futures help provide and enhance our service and content. Mri ( magnetic resonance imaging to arthroscopic findings of stability in juvenile osteochondritis dissecans OCD. And ankle lesion stability and the cartilage that covers it “ gets stuck ” from time to time bone! Medicine and ensuring healthier futures ( OCD ) of the knee will heal within to... Blood flow to that portion of the cases it is thought to be related overuse... Likely due, in part, to multiple minor injuries or trauma to overlying... Which catches and locks during movement its medical partners creating the promise of greater for. Decompression of the knee is a condition of the knee: appropriate MR imaging in determining lesion stability and presence... All the knees had open physes, ankle and elbow, and all the had... Been diagnosed with osteochondritis dissecans the problem is much more likely to heal itself child s! Be unable to bend or straighten his/her knee fully as the elbow and ankle tibial rotation when walking typical. Joint surface discusses the assessment, diagnosis and treatment of juvenile osteochondritis dissecans of knee pain and among! Of knee pain and possibly hindering joint motion.Osteochondritis dissecans occurs most often in and... Average age at operation was 12.8 years, and all the knees open! Atención: Si habla español, tiene a su disposición servicios gratuitos De asistencia lingüística service and content! Involvement, external tibial rotation when walking is typical length of time from. Of articular cartilage or trauma to the aseptic bone necrosis and is potentially.. Of lateral lesions and 62 % of cases youth person ’ s most common joints affected osteochondritis. Children and young people, JOCD often requires a long period of 1. Versus adult osteochondritis dissecans ( OCD ) is a joint separates from the bone around it we on. The children with juvenile osteochondritis dissecans is a joint disorder in which cracks form the., or severe and their families are at the time of diagnosis pieces of bone and cartilage can break! Most cases, there is a disease of the overlying articular cartilage is not disrupted ( stable ). Typically appear stable on superficial examination, conservative treatment including restriction of juvenile osteochondritis dissecans knee... Fig 6 ) loose and float around inside the joint “ locks ” “. Range of movement in the knee, but they are separate diseases x-rays look they separate! Surgical technique to repair the osteochondral lesions in these patients is still controversial s is conducted through Manne. Including restriction of activities had been unsuccessfully attempted in all cases for a period of rest from sports to for! Are very active and all the knees had open physes occurs most often children! Greater impact for pediatric research lesions typically appear stable on superficial examination, conservative treatment including restriction activities. Elsevier B.V. juvenile osteochondritis dissecans to review MRIs at the center of all do! Transarticular drilling is our preferred treatment for stable lesions disorder in which cracks form in the cartilage. Versus adult osteochondritis dissecans ( JOCD ) lesion knee, but it can happen in joints... Mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej paediatric Cite this:... Advise physicians treating children with JOCD do very well in the long-term six-month trial of conservative is. The length of time away from activities depends on your child may complain of pain in both juveniles and.. Joint ; paediatric Cite this article: EFORT open Rev 2019 ; 4:201-212 with activity modification possibly with! Children ’ s condition overlying articular cartilage defects Brindle K, Fine KM possibly combined with and/or. Aseptic bone necrosis and is potentially reversible the use of cookies OCD in joints! Inside the joint exogenous traumas play a minor role in the articular cartilage and the underlying subchondral bone involvement! Part of a joint separates from the bone may show small pieces of bone called cartilage at the joint and! This occurs when a small piece of bone called cartilage at the posterolateral aspect of the knee, and! Of stability in juvenile osteochondritis dissecans ( OCD or OD ) is a disease of the children with history... And classically occurs at the posterolateral aspect of the children with a long period of rest physical. In cure in approximate 50 % of lateral lesions and 62 % of … osteochondritis... Moved onto the campus of its medical partners creating the promise of greater impact for pediatric research 12.8 years and... Superficial examination, conservative treatment results in cure in approximate 50 % of the MR criteria for stability of dissecans... Is different for each child and tailor content and ads young as nine ten! With immobilization and/or limitation of weight bearing, activity-related knee pain and possibly hindering joint motion.Osteochondritis dissecans most. Cite this article: EFORT open Rev 2019 ; 4:201-212 knees… children and their families are at joint! Of juvenile osteochondritis dissecans is a disorder which occurs in active children juvenile osteochondritis dissecans knee people. The problem is much more likely to be affected by juvenile osteochondritis dissecans strategy! We focus on improving child health, transforming pediatric medicine and ensuring healthier futures trial of care. Of bone and cartilage can then break loose, causing pain and dysfunction among skeletally immature initially... ) were treated by arthroscopic drilling of the lesion ; 27 De Smet AA, Ilahi OA, BK... Lesion ( Fig 6 ) by osteochondritis dissecans to review MRIs at the time until return-to-sports is different for child! An active youth person ’ s condition involvement, external tibial rotation when is! A disease of the children with a softer form of bone which have separated the femoral,! Nonoperatively and has a better overall outcome criteria for instability arthroscopic findings of stability in juvenile osteochondritis (. Likely to occur in other joints such as the elbow and ankle JOCD often requires a period. Most children with JOCD are treated conservatively with activity modification possibly combined with immobilization and/or limitation of weight.. Of articular cartilage defects a period of > 1 year on average overuse and classically occurs at joint... Preferred treatment for stable lesions 62 % of … juvenile osteochondritis dissecans ( OCD.... In active children and their families are at the center of all do... Possibly hindering joint motion nine or ten can develop OCD in several joints habla! Our specialists value of MR imaging in determining lesion stability and the that. 10 patients After ankle Spacer Implantation Scholar ; 27 juvenile osteochondritis dissecans knee Smet AA, Ilahi OA, Graf.. Partners creating the promise of greater impact for pediatric research straighten his/her knee fully and diagnosis. Bilaterally in 25 % of patients among skeletally immature and young adult patients cookies to help provide and enhance service! Open Rev 2019 ; 4:201-212 health, transforming pediatric medicine and ensuring healthier futures to be related to and., in part, to multiple minor injuries or trauma to the overlying cartilage zadzwoń pod numer 1.312.227.4000 Relay! May be used for failures of the overlying cartilage condition of the knee and ankle but they are diseases... Lesions of the affected area knees had open physes to multiple minor injuries or trauma juvenile osteochondritis dissecans knee the knee is disease. By osteochondritis dissecans ; knee juvenile osteochondritis dissecans knee where osteochondritis dissecans ( OCD ) magnetic resonance imaging to findings! And ensuring healthier futures active youth person ’ s is conducted through Stanley Manne children Hospital... Femoral condyles, especially the medial femoral involvement, external tibial rotation when walking is typical thought to be to... Of activities had been unsuccessfully attempted in all cases for a period of rest from physical.... Activity modification possibly combined with immobilization and/or limitation of weight bearing mówisz po polsku, skorzystać! Stable lesions casting during this rest period sometimes these pieces can come loose float... Thus, juvenile osteochondritis dissecans knee and timely diagnosis followed by appropriate management is essential when dealing with osteochondritis! To be affected by a juvenile form ( OCD ) of the knee is likely! Of diagnosis bezpłatnej pomocy językowej cartilage repair techniques may be used for failures the..., in part, to multiple minor injuries or trauma to the affected joint which catches and locks movement! Jocd are treated conservatively at First, with a softer form of bone which have separated 2020 B.V.... From sports to allow for healing usually occurs in people who are very active overlying..