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The Pan African Medical Journal 2014
Review
Topics: Abnormalities, Multiple; Adolescent; Adult; Female; Hallux Valgus; Humans; Male; Metatarsal Bones; Metatarsus; Middle Aged; Morocco; Osteochondritis; Osteonecrosis; Osteotomy; Radiography; Retrospective Studies; Young Adult
PubMed: 25419316
DOI: 10.11604/pamj.2014.18.189.4785 -
Annals of the Rheumatic Diseases Apr 1990Zonal necrosis of chondrocytes is a characteristic feature of Kashin-Beck disease. Inferences about chondronecrosis in several spontaneous and experimental arthropathies... (Comparative Study)
Comparative Study Review
Zonal necrosis of chondrocytes is a characteristic feature of Kashin-Beck disease. Inferences about chondronecrosis in several spontaneous and experimental arthropathies of other species may be relevant to the cause of Kashin-Beck disease and conceivably, too, banal osteoarthritis in man.
Topics: Animals; Cartilage Diseases; Dogs; Humans; Necrosis; Osteochondritis
PubMed: 2187418
DOI: 10.1136/ard.49.4.262 -
Seminars in Musculoskeletal Radiology Nov 2014Osteochondral lesions are acquired, potentially reversible injuries of the subchondral bone with or without associated articular cartilage involvement. Injury results in... (Review)
Review
Osteochondral lesions are acquired, potentially reversible injuries of the subchondral bone with or without associated articular cartilage involvement. Injury results in delamination and potential sequestration of the affected bone. Although an association with mechanical and traumatic factors has been established, the etiology remains poorly understood. These lesions commonly occur in the knee; articular surfaces of the elbow, ankle, hip, and shoulder are also affected. Osteochondral lesions are relatively common in children and adolescents, and the incidence is increasing. 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. Many of these lesions are first diagnosed by plain film. MRI adds value by identifying unstable lesions that require surgical intervention. This review focuses on the clinical and imaging features of osteochondral lesions of the knee, elbow, and ankle. Imaging criteria for staging and management are also reviewed.
Topics: Adolescent; Ankle Injuries; Cartilage, Articular; Child; Diagnostic Imaging; Humans; Knee Injuries; Osteochondritis; Elbow Injuries
PubMed: 25350829
DOI: 10.1055/s-0034-1389268 -
Cartilage Dec 2021Osteochondral surgical procedures have been described for the treatment of unfixable osteochondritis dissecans (OCD), but only few of them have been studied for juvenile...
OBJECTIVE
Osteochondral surgical procedures have been described for the treatment of unfixable osteochondritis dissecans (OCD), but only few of them have been studied for juvenile OCD (JOCD) lesions. A cell-free biomimetic osteochondral scaffold showed positive results in adult patients. The aim of this study was to evaluate the results of this scaffold for the treatment of knee JOCD at mid-term follow-up.
DESIGN
Twenty patients (14 males, 6 females) were included in this study. Mean age was 16.2 ± 1.4 years, average defect size was 3.2 ± 1.8 cm, and mean symptoms duration was 20.2 ± 17.9 months. After the implantation of the osteochondral collagen-hydroxyapatite scaffold (Maioregen, Fin-Ceramica, Faenza, Italy), patients were evaluated preoperatively and prospectively at 1, 2, and at final mean follow-up of 6 years (range 5-7 years) with International Knee Documentation Committee (IKDC) subjective and objective, Tegner, and EuroQol visual analogue scale (VAS) scores. MRI evaluation was performed with the MOCART 2.0 score.
RESULTS
All scores showed a significant improvement. IKDC subjective score went from 50.3 ± 17.4 preoperative score to 75.3 ± 14.6 at 1 year ( = 0.002), 80.8 ± 14.6 at 2 years and 85.0 ± 9.3 at 6 years. The Tegner score improved from the preoperative evaluation of 2.6 ± 1.4 to 5.5 ± 2.0 at 6 years ( < 0.0005), although without reaching the level registered before the onset of symptoms. A longer symptoms duration influenced negatively IKDC subjective and Tegner scores up to 2 years ( = 0.003 and = 0.002, respectively) but did not affect the final outcome. Lesion size did not affect the final result. The MOCART 2.0 score showed a significant improvement between 1-year and final follow-up, but with persisting subchondral alterations.
CONCLUSIONS
This study demonstrated a clinical improvement stable over time with a high survival rate, although with persisting abnormal MRI findings, especially at subchondral bone level. This procedure can be considered a suitable option for the treatment of young patients affected by knee OCD. . Case series, level IV.
Topics: Adolescent; Adult; Biomimetics; Cartilage, Articular; Female; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Male; Osteochondritis Dissecans; Tissue Scaffolds
PubMed: 32909451
DOI: 10.1177/1947603520954500 -
Proceedings of the Royal Society of... Aug 1955
Topics: Bone Diseases, Developmental; Disease; Humans; Knee; Osteochondritis; Osteochondrosis
PubMed: 13254737
DOI: No ID Found -
Molecular Genetics & Genomic Medicine Jan 2022Osteochondritis dissecans is a condition wherein there is a subchondral bone lesion that causes pain, inflammation, and cartilage damage. Dominant Familial...
BACKGROUND
Osteochondritis dissecans is a condition wherein there is a subchondral bone lesion that causes pain, inflammation, and cartilage damage. Dominant Familial Osteochondritis Dissecans is a rare and severe form of osteochondritis dissecans (OCD). It is caused by heterozygous pathogenic variants in the gene encoding Aggrecan; ACAN. Aggrecan, a proteoglycan, is an essential component of the articular and growth plate cartilage.
METHODS
Herein, we report three individuals from one family; the proband who presented with short stature, a lower limb bone exostosis, and bilateral knee and elbow OCD at the age of 13 years old. His twin brother presented with isolated short stature and his father with short stature and lumbar disc herniation.
RESULTS
Next-generation sequencing of the ACAN gene in the proband identified a frameshift variant which is also present in the brother and father with short stature. The proband was treated surgically with bilateral elbow microfracture, after the failure of conservative therapy.
CONCLUSION
To the best of our knowledge, this is the first patient with an aggrecanopathy who presents with osteochondritis dissecans due to a frameshift variant. This family presents with variable expressivity which might be attributed to modifier genes.
Topics: Adolescent; Aggrecans; Dwarfism; Heterozygote; Humans; Intervertebral Disc Displacement; Male; Osteochondritis Dissecans
PubMed: 34894100
DOI: 10.1002/mgg3.1773 -
Sichuan Da Xue Xue Bao. Yi Xue Ban =... Mar 2024Osteochondral lesion of the talus (OLT) is a localized cartilage and subchondral bone injury of the talus trochlea. OLT is caused by trauma and other reasons, including... (Review)
Review
Osteochondral lesion of the talus (OLT) is a localized cartilage and subchondral bone injury of the talus trochlea. OLT is caused by trauma and other reasons, including osteochondritis dissecans of the talus (OCD) and talus osteochondral tangential fracture. OLT can develop from being asymptomatic to subchondral bone cysts accompanied by deep ankle pain. OLT tends to occur on the medial and lateral sides of the talar vault. OLT seriously affects the patients' life and work and may even lead to disability. Herein, we reviewed advances in the treatment of OLT and the strengths and weaknesses of various treatments. Different treatment methods, including conservative treatments and surgical treatments, can be adopted according to the different subtypes or clinical symptoms of OLT. Conservative treatments mostly relieve symptoms in the short term and only slow down the disease. In recent years, it has been discovered that platelet-rich plasma injection, microfracture, periosteal bone grafting, talar cartilage transplantation, allograft bone transplantation, reverse drilling under robotic navigation, and other methods can achieve considerable benefits when each of these treatment methods is applied. Furthermore, microfracture combined with platelet-rich plasma injections, microfracture combined with cartilage transplantation, and various other treatment methods combined with anterior talofibular ligament repair have all led to good treatment outcomes.
Topics: Talus; Humans; Bone Transplantation; Platelet-Rich Plasma; Osteochondritis Dissecans; Cartilage; Arthroplasty, Subchondral; Cartilage, Articular
PubMed: 38645844
DOI: 10.12182/20240360206 -
Knee Surgery, Sports Traumatology,... Nov 2023To investigate the current preferences regarding the work-up and treatment choices of juvenile osteochondritis dissecans (JOCD) of the knee, ankle and elbow among...
PURPOSE
To investigate the current preferences regarding the work-up and treatment choices of juvenile osteochondritis dissecans (JOCD) of the knee, ankle and elbow among orthopaedic surgeons.
METHODS
An international survey was set up for all European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA) members, which assessed various questions on diagnosis and treatment of JOCD of different joints. Respondents answered questions for one or more joints, based on their expertise. Proportions of answers were calculated and compared between joints. Consensus was defined as more than 75% agreement on an item; disagreement was defined as less than 25% agreement.
RESULTS
Fifty physicians responded to the survey, of whom forty-two filled out the questions on the knee, fourteen on the ankle and nine on the elbow. Plain radiography and MRI were the most used imaging modalities for the assessment and follow-up of JOCD in the knee and ankle, but not for the elbow. MRI was also the preferred method to assess the stability of a lesion in the knee and ankle. There was universal agreement on activity and/or sports restriction as the non-operative treatment of choice for JOCD. Size, stability and physeal closure were the most important prognostic factors in determining the operative technique for the elbow. For the knee, these factors were size and stability and for the ankle, these were size and location.
CONCLUSION
Activity and/or sports restriction was the non-operative treatment of choice. Furthermore, plain radiography and MRI were the preferred imaging modalities for the knee and ankle, but not for the elbow. For determining the operative technique, physicians agreed that the size of the lesion is an important prognostic factor in all joints. These findings help us understand how juvenile osteochondritis dissecans is treated in current practice and may provide opportunities for improvement.
LEVEL OF EVIDENCE
Level V.
Topics: Humans; Osteochondritis Dissecans; Ankle; Elbow; Knee; Knee Joint; Physicians
PubMed: 37787862
DOI: 10.1007/s00167-023-07563-0 -
Acta Orthopaedica Aug 2018Background and purpose - The frequency of progression of osteoarthritis and persistence of symptoms in untreated osteochondral lesion of the talus (OCL) is not well...
Background and purpose - The frequency of progression of osteoarthritis and persistence of symptoms in untreated osteochondral lesion of the talus (OCL) is not well known. We report the outcome of a nonoperative treatment for symptomatic OCL. Patients and methods - This study included 142 patients with OCLs from 2003 to 2013. The patients did not undergo immobilization and had no restrictions of physical activities. The mean follow-up time was 6 (3-10) years. Initial MRI and CT confirmed OCL and showed lesion size, location, and stage of the lesion. Progression of osteoarthritis was evaluated by standing radiographs. In 83 patients, CT was performed at the final follow-up for analyses of the lesion size. We surveyed patients for limitations of sports activity, and Visual Analogue Scales (VAS), AOFAS, and SF-36 were assessed. Results - No patients had progression of osteoarthritis. The lesion size as determined by CT did not change in 69/83 patients, decreased in 5, and increased in 9. The mean VAS score of the 142 patients decreased from 3.8 to 0.9 (p < 0.001), the mean AOFAS ankle-hindfoot score increased from 86 to 93 (p < 0.001), and the mean SF-36 score increased from 52 to 72 (p < 0.001). Only 9 patients reported limitations of sports activity. The size and location of the lesion did not correlate with any of the outcome scores. Interpretation - Nonoperative treatment can be considered a good option for patients with OCL.
Topics: Adult; Disease Progression; Female; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Observer Variation; Osteoarthritis; Osteochondritis; Radiography; Retrospective Studies; Talus; Treatment Outcome; Weight-Bearing
PubMed: 29635971
DOI: 10.1080/17453674.2018.1460777 -
Osteoarthritis and Cartilage Dec 2018
Topics: Cartilage, Articular; Humans; Knee Joint; Obsessive-Compulsive Disorder; Osteochondritis Dissecans; Osteochondrosis
PubMed: 30248502
DOI: 10.1016/j.joca.2018.09.008