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The Journal of Bone and Joint Surgery.... Jun 2021Osteochondritis dissecans occurs most frequently in the active pediatric and young adult populations, commonly affecting the knee, elbow, or ankle, and may lead to... (Review)
Review
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Osteochondritis dissecans occurs most frequently in the active pediatric and young adult populations, commonly affecting the knee, elbow, or ankle, and may lead to premature osteoarthritis.
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While generally considered an idiopathic phenomenon, various etiopathogenetic theories are being investigated, including local ischemia, aberrant endochondral ossification of the secondary subarticular physis, repetitive microtrauma, and genetic predisposition.
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Diagnosis is based on the history, physical examination, radiography, and advanced imaging, with elbow ultrasonography and novel magnetic resonance imaging protocols potentially enabling early detection and in-depth staging.
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Treatment largely depends on skeletal maturity and lesion stability, defined by the presence or absence of articular cartilage fracture and subchondral bone separation, as determined by imaging and arthroscopy, and is typically nonoperative for stable lesions in skeletally immature patients and operative for those who have had failure of conservative management or have unstable lesions.
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Clinical practice guidelines have been limited by a paucity of high-level evidence, but a multicenter effort is ongoing to develop accurate and reliable classification systems and multimodal decision-making algorithms with prognostic value.
Topics: Arthroscopy; Humans; Osteochondritis Dissecans; Radiography
PubMed: 34109940
DOI: 10.2106/JBJS.20.01399 -
Cartilage Dec 2021This is a review on talus osteochondritis dissecans and talus osteochondral lesions. A majority of the osteochondral lesions are associated with trauma while the cause... (Review)
Review
This is a review on talus osteochondritis dissecans and talus osteochondral lesions. A majority of the osteochondral lesions are associated with trauma while the cause of pure osteochondritis dissecans is still much discussed with a possible cause being repetitive microtraumas associated with vascular disturbances causing subchondral bone necrosis and disability. Symptomatic nondisplaced osteochondral lesions can often be treated conservatively in children and adolescents while such treatment is less successful in adults. Surgical treatment is indicated when there is an unstable cartilage fragment. There are a large number of different operative technique options with no number one technique to be recommended. Most techniques have been presented in level II to IV studies with a low number of patients with short follow ups and few randomized comparisons exist. The actual situation in treating osteochondral lesions in the ankle is presented and discussed.
Topics: Adolescent; Adult; Ankle Joint; Arthroscopy; Child; Humans; Intra-Articular Fractures; Magnetic Resonance Imaging; Osteochondritis Dissecans; Osteonecrosis; Talus; Tomography, X-Ray Computed
PubMed: 33423507
DOI: 10.1177/1947603520985182 -
Orthopaedics & Traumatology, Surgery &... Feb 2018Osteochondritis dissecans (OCD) of the knee is an idiopathic, focal, subchondral-bone abnormality that can cause instability or detachment of a bone fragment and... (Review)
Review
Osteochondritis dissecans (OCD) of the knee is an idiopathic, focal, subchondral-bone abnormality that can cause instability or detachment of a bone fragment and overlying articular cartilage, with subsequent progression to osteoarthritis. The diagnosis is usually made during adolescence. Mechanical factors play a major role in the pathophysiology of OCD. When the radiographic diagnosis is made early in a patient with open physes, healing can often be obtained simply by restricting sports activities. The degree of lesion instability can be assessed by magnetic resonance imaging. When the lesion remains unstable and the pain persists despite a period of rest, surgery is indicated. Arthroscopic exploration is always the first step. Drilling of the lesion produces excellent outcomes if the lesion is stable. Unstable lesions require fixation and, in some cases, bone grafting. Defects must be filled, depending on their surface area. Although many surgical techniques are available, the therapeutic indications are now standardized.
Topics: Arthralgia; Arthroscopy; Humans; Knee Joint; Magnetic Resonance Imaging; Osteoarthritis, Knee; Osteochondritis Dissecans; Radiography
PubMed: 29197636
DOI: 10.1016/j.otsr.2017.02.016 -
British Journal of Hospital Medicine... Apr 2023Osteochondritis dissecans is a condition characterised by acquired pathological subchondral bone lesions and its incidence is unknown. It has a multifactorial aetiology,...
Osteochondritis dissecans is a condition characterised by acquired pathological subchondral bone lesions and its incidence is unknown. It has a multifactorial aetiology, with a combination of genetic and acquired risk factors. It commonly presents in adolescents and young adults. Patients have variable presentations, including trauma, insidious onset and pain exacerbated by exercise. The joints primarily affected are the knee, ankle and elbow joint. Early identification is key to treatment and to prevent future osteoarthritis of the joint. This article gives an overview of the presentation, assessment and management of the juvenile form of osteochondritis dissecans.
Topics: Adolescent; Young Adult; Humans; Osteochondritis Dissecans; Knee Joint
PubMed: 37127418
DOI: 10.12968/hmed.2023.0044 -
British Journal of Sports Medicine Nov 2007Elbow injuries constitute a sizeable percentage of tennis injuries. A basic understanding of biomechanics of tennis and analysis of the forces, loads and motions of the... (Review)
Review
Elbow injuries constitute a sizeable percentage of tennis injuries. A basic understanding of biomechanics of tennis and analysis of the forces, loads and motions of the elbow during tennis will improve the understanding of the pathophysiology of these injuries. All different strokes in tennis have a different repetitive biomechanical nature that can result in tennis-related injuries. In this article, a biomechanically-based evaluation of tennis strokes is presented. This overview includes all tennis-related pathologies of the elbow joint, whereby the possible relation of biomechanics to pathology is analysed, followed by treatment recommendations.
Topics: Athletic Injuries; Biomechanical Phenomena; Elbow Joint; Humans; Osteochondritis Dissecans; Range of Motion, Articular; Shoulder Impingement Syndrome; Tendinopathy; Tennis; Tennis Elbow; Ulnar Neuropathies; Elbow Injuries
PubMed: 17638843
DOI: 10.1136/bjsm.2007.038307 -
Theranostics 2019Mitochondrial dysfunction and oxidative stress damage are hallmarks of osteoarthritis (OA). Mesenchymal stem cell (MSC)-derived exosomes are important in intercellular...
Mitochondrial dysfunction and oxidative stress damage are hallmarks of osteoarthritis (OA). Mesenchymal stem cell (MSC)-derived exosomes are important in intercellular mitochondria communication. However, the use of MSC exosomes for regulating mitochondrial function in OA has not been reported. This study aimed to explore the therapeutic effect of MSC exosomes in a three dimensional (3D) printed scaffold for early OA therapeutics. : We first examined the mitochondria-related proteins in normal and OA human cartilage samples and investigated whether MSC exosomes could enhance mitochondrial biogenesis . We subsequently designed a bio-scaffold for MSC exosomes delivery and fabricated a 3D printed cartilage extracellular matrix (ECM)/gelatin methacrylate (GelMA)/exosome scaffold with radially oriented channels using desktop-stereolithography technology. Finally, the osteochondral defect repair capacity of the 3D printed scaffold was assessed using a rabbit model. : The ECM/GelMA/exosome scaffold effectively restored chondrocyte mitochondrial dysfunction, enhanced chondrocyte migration, and polarized the synovial macrophage response toward an M2 phenotype. The 3D printed scaffold significantly facilitated the cartilage regeneration in the animal model. : This study demonstrated that the 3D printed, radially oriented ECM/GelMA/exosome scaffold could be a promising strategy for early OA treatment.
Topics: Animals; Biocompatible Materials; Cartilage; Cell Movement; Chondrocytes; Disease Models, Animal; Exosomes; Extracellular Matrix; Female; Gelatin; Humans; Ink; Macrophages; Mesenchymal Stem Cells; Methacrylates; Mitochondria; Osteochondritis; Printing, Three-Dimensional; Rabbits; Regeneration; Stereolithography; Tissue Scaffolds
PubMed: 31131046
DOI: 10.7150/thno.31017 -
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 -
Ugeskrift For Laeger Nov 2017Osteochondritis dissecans (OCD) has been known for more than 100 years. Several reasons have been suggested as the major cause for developing OCD: trauma/microtrauma,... (Review)
Review
Osteochondritis dissecans (OCD) has been known for more than 100 years. Several reasons have been suggested as the major cause for developing OCD: trauma/microtrauma, ischaemic or genetic reasons. OCD is primarily located in the knee. In adolescent patients with knee symptoms, X-ray of the affected knee and often a subsequent MRI scan is indicated. Depending on the findings, an arthroscopy can be performed. Conservative treatment can be quiet regime or bracing. Operative treatment can be transchondral/retrograde drilling for the in situ lesion or fixation of the unstable lesion.
Topics: Adolescent; Adult; Child; Female; Humans; Knee Joint; Magnetic Resonance Imaging; Osteochondritis Dissecans; Young Adult
PubMed: 29208201
DOI: No ID Found -
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 -
Deutsches Arzteblatt International May 2020
Topics: Humans; Osteochondritis
PubMed: 32616147
DOI: 10.3238/arztebl.2020.0343