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Current Reviews in Musculoskeletal... Apr 2020Osteochondritis dissecans (OCD) is a pathologic condition of subchondral bone most frequently occurring in the medial femoral condyle of the knee in children and... (Review)
Review
PURPOSE OF THE REVIEW
Osteochondritis dissecans (OCD) is a pathologic condition of subchondral bone most frequently occurring in the medial femoral condyle of the knee in children and adolescents. Salvage techniques are necessary when either nonoperative or typical operative treatments fail, or the OCD presents in an unsalvageable state. The purpose of this review is to describe the evaluation and management of failed OCDs.
RECENT FINDINGS
Thorough preoperative planning is essential to the treatment of failed OCDs. Radiographs and advanced imaging such as MRI and CT allow for a detailed assessment of subchondral bone and cartilage. Long-leg alignment radiographs are critical to assess for malalignment which may increase the contact forces on the affected condyle. Malalignment can be corrected with hemiepiphysiodesis or an osteotomy depending on the skeletal maturity of the patient. Osteochondral allografts and autologous chondrocyte implantation treat the defect in both bone and cartilage or solely cartilage and have good short to moderate term outcomes, particularly as compared to the inferior outcomes of microfracture of larger OCDs. Osteochondritis dissecans of the knee that fails to heal with initial operative measures can result in a large defect of bone and cartilage in the knee of adolescents. Treatment of the bone and cartilage defect can be accomplished with either osteochondral allograft transplantation or matrix-assisted autologous chondrocyte implantation can be performed with good outcomes. Assessment and correction of lower extremity malalignment is a critical component of treatment. Durable long-term solutions are necessary for the treatment of these difficult lesions.
PubMed: 32147780
DOI: 10.1007/s12178-020-09611-5 -
BMJ Case Reports Oct 2019
Topics: Diagnosis, Differential; Humans; Male; Metatarsophalangeal Joint; Metatarsus; Osteochondritis; Range of Motion, Articular; Young Adult
PubMed: 31604724
DOI: 10.1136/bcr-2019-232171 -
Veterinary and Comparative Orthopaedics... Mar 2021
Topics: Animals; Dog Diseases; Dogs; Minimally Invasive Surgical Procedures; Orthopedic Procedures; Orthopedics; Osteochondritis Dissecans; Shoulder
PubMed: 33725735
DOI: 10.1055/s-0041-1725062 -
Foot and Ankle Clinics Dec 2019Freiberg's infraction is an uncommon condition of the lesser metatarsophalangeal joints. Onset is usually between the 11th and 17th year of age. It is the only... (Review)
Review
Freiberg's infraction is an uncommon condition of the lesser metatarsophalangeal joints. Onset is usually between the 11th and 17th year of age. It is the only osteochondrosis that dominantly affects females with a reported female-to-male ratio of 5.1. The second metatarsal is most frequently involved (68%) followed by the third metatarsal (27%), and the fourth (3%). Surgical treatment options can be categorized in joint destructive and joint preserving procedures. Studies reveal complete resolution of pain and full return to activities in 70% after joint destructive procedure and more than 90% after joint preserving procedures.
Topics: Arthroplasty; Bone Transplantation; Debridement; Decompression, Surgical; Humans; Metatarsal Bones; Metatarsophalangeal Joint; Metatarsus; Osteochondritis; Osteotomy
PubMed: 31653371
DOI: 10.1016/j.fcl.2019.08.004 -
Biomaterials Research Aug 2023Various joint pathologies such as osteochondritis dissecans, osteonecrosis, rheumatic disease, and trauma, may result in severe damage of articular cartilage and other... (Review)
Review
Various joint pathologies such as osteochondritis dissecans, osteonecrosis, rheumatic disease, and trauma, may result in severe damage of articular cartilage and other joint structures, ranging from focal defects to osteoarthritis (OA). The osteochondral unit is one of the critical actors in this pathophysiological process. New approaches and applications in tissue engineering and regenerative medicine continue to drive the development of OA treatment. Hydrogel scaffolds, a component of tissue engineering, play an indispensable role in osteochondral regeneration. In this review, tissue engineering strategies regarding osteochondral regeneration were highlighted and summarized. The application of hydrogels for osteochondral regeneration within the last five years was evaluated with an emphasis on functionalized physical and chemical properties of hydrogel scaffolds, functionalized delivery hydrogel scaffolds as well as functionalized intelligent response hydrogel scaffolds. Lastly, to serve as guidance for future efforts in the creation of bioinspired hydrogel scaffolds, a succinct summary and new views for specific mechanisms, applications, and existing limitations of the newly designed functionalized hydrogel scaffolds were offered.
PubMed: 37542353
DOI: 10.1186/s40824-023-00411-9 -
Clinics in Podiatric Medicine and... Jul 2024Osteochondral lesions of the talus are a common sequelae of trauma and are often associated with ankle sprains and ankle fractures. Because the surface of the talus is... (Review)
Review
Osteochondral lesions of the talus are a common sequelae of trauma and are often associated with ankle sprains and ankle fractures. Because the surface of the talus is composed primarily of hyaline cartilage, the regenerative capacity of these injuries is limited. Therefore, several open and arthroscopic techniques have been described to treat osteochondral injuries of the talus and underlying bone marrow lesions. Throughout this review, these treatment options are discussed along with their indications and currently reported outcomes. A commentary on the authors' preferences among these techniques is also provided.
Topics: Humans; Talus; Arthroscopy; Cartilage, Articular; Ankle Injuries; Male; Female
PubMed: 38789163
DOI: 10.1016/j.cpm.2024.01.004 -
Cartilage Oct 2021This review presents the current understanding of the etiology, pathogenesis, and how to diagnose and treat osteochondritis dissecans (OCD) at the elbow joint followed... (Review)
Review
This review presents the current understanding of the etiology, pathogenesis, and how to diagnose and treat osteochondritis dissecans (OCD) at the elbow joint followed by an analysis of particular characteristics and outcomes of the treatment. OCD is seen in patients with open growth plates (juvenile OCD [JOCD] and in adults [AOCD] with closed growth plates [adult OCD). The etiology at smaller joints remains as unclear as for the knee. Mechanical factors (throwing activities [capitulum] seem to play an important role. Clinical symptoms are unspecific. Thus, imaging techniques are most important for the diagnosis. In low-grade and stable lesions, treatment involves rest and different degrees of immobilization until healing. When surgery is necessary, the procedure depends on the OCD stage and on the state of the cartilage. With intact cartilage, retrograde procedures are favorable while with damaged cartilage, several techniques are used. Techniques such as drilling and microfracturing produce a reparative cartilage while other techniques reconstruct the defect with osteochondral grafts or cell-based procedures such as chondrocyte implantation. There is a tendency toward better results when reconstructive procedures for both the bone and cartilage are used. In addition, comorbidities at the joint have to be treated. Severe grades of osteoarthritis are rare.
Topics: Chondrocytes; Elbow; Elbow Joint; Humans; Knee Joint; Osteochondritis Dissecans
PubMed: 31113206
DOI: 10.1177/1947603519847735 -
Wiley Interdisciplinary Reviews.... Nov 2019In the past few decades, nanotechnology has proven to be one of the most powerful engineering strategies. The nanotechnologies for osteochondral tissue engineering aim... (Review)
Review
In the past few decades, nanotechnology has proven to be one of the most powerful engineering strategies. The nanotechnologies for osteochondral tissue engineering aim to restore the anatomical structures and physiological functions of cartilage, subchondral bone, and osteochondral interface. As subchondral bone and articular cartilage have different anatomical structures and the physiological functions, complete healing of osteochondral defects remains a great challenge. Considering the limitation of articular cartilage to self-healing and the complexity of osteochondral tissue, osteochondral defects are in urgently need for new therapeutic strategies. This review article will concentrate on the most recent advancements of nanotechnologies, which facilitates chondrogenic and osteogenic differentiation for osteochondral regeneration. Moreover, this review will also discuss the current strategies and physiological challenges for the regeneration of osteochondral tissue. Specifically, we will summarize the latest developments of nanobased scaffolds for simultaneously regenerating subchondral bone and articular cartilage tissues. Additionally, perspectives of nanotechnology in osteochondral tissue engineering will be highlighted. This review article provides a comprehensive summary of the latest trends in cartilage and subchondral bone regeneration, paving the way for nanotechnologies in osteochondral tissue engineering. This article is categorized under: Implantable Materials and Surgical Technologies > Nanomaterials and Implants Nanotechnology Approaches to Biology > Nanoscale Systems in Biology Implantable Materials and Surgical Technologies > Nanotechnology in Tissue Repair and Replacement.
Topics: Animals; Chondrogenesis; Humans; Nanoparticles; Nanotechnology; Osteogenesis; Regeneration; Tissue Scaffolds
PubMed: 31329375
DOI: 10.1002/wnan.1576 -
The Orthopedic Clinics of North America Jan 2020Osteochondritis dissecans (OCD) of the capitellum is a relatively rare condition, with a higher incidence in adolescents who participate in repetitive overhead sports.... (Review)
Review
Osteochondritis dissecans (OCD) of the capitellum is a relatively rare condition, with a higher incidence in adolescents who participate in repetitive overhead sports. The surgical treatment approach for this uncommon problem has varied from microfracture, loose body removal, abrasion chrondroplasty, lesion fixation, osteochondral allograft transplantation surgery, and osteochondral autologous transplantation surgery. The purpose of this study is to present the authors' preferred surgical technique for the treatment of unstable OCD lesions of the capitellum with osteochondral autologous transplantation surgery using autograft from the ipsilateral knee.
Topics: Adolescent; Cartilage, Articular; Child; Elbow Joint; Female; Fractures, Stress; Humans; Humerus; Incidence; Knee Joint; Magnetic Resonance Imaging; Male; Osteochondritis Dissecans; Radiography; Plastic Surgery Procedures; Sports; Transplantation, Autologous; Treatment Outcome
PubMed: 31739884
DOI: 10.1016/j.ocl.2019.08.004 -
The British Journal of General Practice... Aug 2019
Topics: General Practitioners; Humans; Metatarsus; Osteochondritis; Rare Diseases; Referral and Consultation
PubMed: 31345815
DOI: 10.3399/bjgp19X704849