Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Symposium: Osteochondritis Dissecans 12 articles


Biographical Sketch: Franz König, MD 1832–1910

Richard A. Brand MD [object Object],(Translated by Drs. Richard A. Brand and Christian-Dominik Peterlein).

Osteochondritis Dissecans Knee Histology Studies Have Variable Findings and Theories of Etiology

Kevin G. Shea MD, John C. Jacobs BS, James L. Carey MD, MPH, Allen F. Anderson MD, Julia T. Oxford PhD

Although many etiological theories have been proposed for osteochondritis dissecans (OCD), its etiology remains unclear. Histological analysis of the articular cartilage and subchondral bone tissues of OCD lesions can provide useful information about the cellular changes and progression of OCD. Previous research is predominantly comprised of retrospective clinical studies from which limited conclusions can be drawn.

Can Fresh Osteochondral Allografts Restore Function in Juveniles With Osteochondritis Dissecans of the Knee?

Roger Lyon MD, Carl Nissen MD, Xue Cheng Liu MD, PhD, Brian Curtin MD

Failure of initial treatment for juvenile osteochondritis dissecans (OCD) may require further surgical intervention, including microfracture, autograft chondrocyte implantation, osteochondral autografting, and fresh osteochondral allografting. Although allografts and autografts will restore function in most adults, it is unclear whether fresh osteochondral allograft transplantations similarly restore function in skeletally immature patients who failed conventional treatment.

Oligo[poly(ethylene glycol)fumarate] Hydrogel Enhances Osteochondral Repair in Porcine Femoral Condyle Defects

James H. Hui FRCS, MD, Xiafei Ren PhD, Mohd Hassan Afizah MSc, Kerm Sin Chian PhD, Antonios G. Mikos PhD

Management of osteochondritis dissecans remains a challenge. Use of oligo[poly(ethylene glycol)fumarate] (OPF) hydrogel scaffold alone has been reported in osteochondral defect repair in small animal models. However, preclinical evaluation of usage of this scaffold alone as a treatment strategy is limited.

Preoperative Imaging Criteria for Unstable Osteochondritis Dissecans of the Capitellum

Hiroshi Satake MD, PhD, Masatoshi Takahara MD, PhD, Mikio Harada MD, PhD, Masahiro Maruyama MD

The stability of an osteochondritis dissecans (OCD) lesion of the humeral capitellum may be determined by intraoperative probing with unstable lesions being displaceable. Although preoperative imaging is used to diagnose and determine treatment of these lesions, it is unclear whether unstable lesions on imaging correspond to those found intraoperatively.

Does Extracorporeal Shock Wave Therapy Enhance Healing of Osteochondritis Dissecans of the Rabbit Knee?: A Pilot Study

Roger Lyon MD, Xue Cheng Liu MD, PhD, Martin Kubin MD, Joseph Schwab MD

Severe osteochondritis dissecans (OCD) in children and adolescents often necessitates surgical interventions (ie, drilling, excision, or débridement). Since extracorporeal shock wave therapy (ESWT) enhances healing of long-bone nonunion fractures, we speculated ESWT would reactivate the healing process in OCD lesions.

Cell-based Therapy Improves Function in Adolescents and Young Adults With Patellar Osteochondritis Dissecans

Bryon J. X. Teo, Kizher Buhary BEng, Bee-Choo Tai PhD, James H. Hui FRCS

Recent advances have been made in using chondrocytes and other cell-based therapy to treat cartilage defects in adults. However, it is unclear whether these advances should be extended to the adolescent and young adult-aged patients.

Three Osteochondritis Dissecans Lesions in One Knee: A Case Report

Nathan L. Grimm BS, Breann Tisano BS, James L. Carey MD, MPH

Osteochondritis dissecans (OCD) has been defined as a localized process in which a focus of subchondral bone and adjacent articular cartilage separates from the surrounding bone. With the knee being the most common location for OCD development and the propensity for this lesion to be found in those who participate in sports, a repetitive microtrauma hypothesis for its cause has gained favor. However, the cause of OCD remains controversial, as does the most appropriate treatment for the varying degrees of OCD lesions.

A Review of Knowledge in Osteochondritis Dissecans: 123 Years of Minimal Evolution from König to the ROCK Study Group

Eric W. Edmonds MD, John Polousky MD

Osteochondritis dissecans (OCD) was first described to provide an explanation for the nontraumatic development of loose bodies within a joint. Despite many reports on the subject, there remains no clear understanding of the etiology, natural history, or treatment.

Drilling Juvenile Osteochondritis Dissecans: Retro- or Transarticular?

Matthew J. Gunton MD, James L. Carey MD, MPH, Colin R. Shaw BSc (Hons), MSc, M. Lucas Murnaghan MD, MEd, FRCSC

Early diagnosis and successful treatment of juvenile osteochondritis dissecans (JOCD) is essential in preventing articular degeneration at a young age. Surgical treatment of stable JOCD lesions failing nonoperative treatment involves retroarticular or transarticular drilling to induce revascularization and healing. Multiple case series report high healing rates and infrequent complications for both retroarticular and transarticular drilling modalities; however, it is unclear from these individual reports whether one mode of drilling provides higher healing rates.