Osteochondral tissue harvested from fresh allograft talus and transplanted into the defect Best for large (>3 cm 2 ) lesions, as an alternative to arthrodesis ( 10 ) 66% success rate ( 11 ) The devices of MaioRegen system are indicated for the treatment of cartilage and osteochondral joint surface lesions . age younger age correlates with better prognosis; open distal femoral physes are the best predictor of successful non-operative management ; location lesions in lateral femoral condyle and patella have poorer prognosis; appearance . Causes There were 41% failures in the microfracture group compared with none in the mosaic osteochondral autograft transplantation group at the final follow-up. Osteochondritis dissecans of the talus is a particular form of osteochondral lesions of the talus. The older patients may not respond to less invasive surgeries such as subchondral bone drilling. One common abnormality I see in the elbow is something called an OCD or an Osteochondral Defect. Displaced osteochondral fragment. Clin Sports Med 1997; 16:157. If you suffer an ankle sprain (or any kind of trauma to the ankle) and the cartilage fails to heal properly, bits of cartilage may break off and float around in the space between the bones in your ankle. juvenile form. L.M. When I see a child with an OCD of the elbow, we initiate treatment by limiting activities and sometimes simply backing off on gymnastics or baseball may be enough to help control the symptoms and allow the elbow to heal. Patient factors: Individual patient factors, including patient preferences, alignment of the lower extremities, social resources, work/job demands, and medical comorbidities must be considered when evaluating these patients. OCD and other traumatic injuries can lead to large osteochondral defects of the knee. Chondral and osteochondral lesions of the humeral capitellum, most notably osteochondritis dissecans, most commonly present in adolescent baseball players and gymnasts. One common abnormality I see in the elbow is something called an OCD or an A trauma with subsequent osteochondral defect detected immediately by radiology has to be differentiated from osteochondritis dissecans of the talus. Animals— Dogs (n=27) with medial humeral condylar OCD. It occurs when a small segment of bone begins to separate from its surrounding region due to a lack of blood supply. Some small series of clinical applications of this procedure for advanced osteochondritis dissecans of the humeral capitellum, with short-term follow-up, have been reported; however, longer-term outcomes remain unclear. In clinical practice, the abbreviation OCD is often used for both osteochondral defect and osteochondritis dissecans, which causes confusion. Marrow stimulation, although relatively simple to perform, has several limitations. Osteochondraldefect is a broad term that describes the morphological change of a localized gap in the articular cartilage and subchondral bone 5. Large defects cannot be filled due to donor site morbidity, and there may be problems with articular cartilage incongruence. Osteochondritis dissecans (OCD) is a focal idiopathic alteration of subchondral bone with risk for instability and disruption of adjacent articular cartilage that may result in premature osteoarthritis. This approach may be reasonable for smaller OCD lesions. Animals: Dogs (n=14) with caudocentral humeral head OCD (16 shoulders). Osteochondral Defect listed as OCD Looking for abbreviations of OCD? Articular Cartilage Defects of Knee ... osteochondral separation with loose bodies; Prognosis. Osteochondritis Dissecans Typically, a sports injury due to stressful twisting motions of the shinbone or thighbone, osteochondritis dissecans is any damage to the cartilage coating of the bone. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. 4921 Parkview Place Amazon workers plan Black Friday strikes and protests. Consequently, in lesions that are small, mosaic osteochondral autograft transplantation is a reasonable procedure that produces outcomes that are superior to microfracture. Objective: To establish whether osteochondral autograft transfer (OAT) procedures for osteochondritis dissecans (OCD) of the canine caudocentral humeral head would restore articular contour, resurface osteochondral defects, and resolve lameness in dogs with OCD. It is Osteochondral Defect. Study Design— Case series. It can be in the dominant hand or the non-dominant hand and it typically causes pain but also can cause other problems which we call mechanical problems which include locking of the elbow, popping in the elbow and an inability to perform daily activities. St. Louis, MO 63129, 20 Progress Point Parkway, Suite 114 In cases in which the subchondral bone is minimally involved, standard ACI may be considered. The use of a fresh osteochondral allograft for treatment of a lesion of the femoral condyle is relatively new, and we report its use in a unique situation involving identical twins who both presented with osteochondritis dissecans of the same anatomic location within 2 years of each other. Osteochondritis dissecans (OCD) is a condition that develops in joints, most often in children and adolescents. Nonoperative management may consist of activity modifications, maintenance of ideal body weight, and low-impact conditioning programs. In addition, osteochondral allografts produce enough graft material to resurface larger lesions. Evaluation of the Agili-C Biphasic Implant in … Osteochondral allograft transplantation has a long history, dating back to 1957, when Smillie proposed its use for OCD. Due to the loss and/or abnormalities of the subchondral bone base, special ACI approaches have been developed. Figure 1. Patients with acute, traumatic cartilage injury with displaced fragments may be candidates for surgery. In 1888, Konig coined the term when he sought to describe the pathologic process that led to atraumatic loose bodies of femoral origin in the knee and hip joints. Most kids do well when they have this problem although we typically encourage the families to avoid the offending activity so if this seen in a high level gymnast and the elbow doesn't heal fully, that patient may or may not be able to get back to gymnastics as they performed before. The MRI may also reveal kissing lesions, in which there is chondral injury on opposing articular surfaces. use of any information on these sites. Microfracture may not have a role in the treatment of osteochondritits dissecans if the subchondral bone is violated. Chesterfield, MO 63017, 1044 N. Mason Road OCD lesions occur when a segment of subchondral bone… Notable findings include effusion, joint line tenderness, and, in some cases, a mobile free body may be palpated. Background: Costal osteochondral grafting is a technique to achieve anatomical and biological repair of articular defects. Once your diagnostic examination is complete, the Physical Therapists at Rocky Mountain Therapy Services have treatment options that will help speed your recovery, so that you can more quickly return to your active lifestyle. Many patients, especially those who are skeletally immature, with significant growth remaining, have good potential for healing with appropriate activity modification, and in select cases, subchondral bone drilling. Completely detached osteochondral fragment remaining in the crater. The natural history of OCD runs a variable course. Suite 1500 Fixation of the osteochondral fragment was achieved with autogenous osteochondral plugs through a posterior arthrotomy. Definition and symptoms. The Department of Orthopaedic Surgery at Washington University School of Medicine in St. Louis has no control over third-party websites and does not review such websites. This chapter focuses on the use osteochondral allografts to address these large, irreparable defects. Review of previous imaging studies (typically radiographs and/or magnetic resonance imaging [MRI]), operative reports, and arthroscopic imaging is critical in the evaluation of these patients. At 8 months after surgery, the patient was able to return to his former competitive level of performance. Partially detached osteochondral fragment. prognosis correlates with . If that fails to lead to improvement or if there are mechanical symptoms, which is the locking or catching of the elbow, then we have to think more aggressively and typically that involves surgical intervention. Please note that OCD is a commonly used abbreviation for both osteochondral defect and osteochondritis dissecans, two closely related conditions. Osteochondritis dissecans (OCD) is a subchondral bone abnormality that affects the overlying articular cartilage with bony and cartilage fragmentation and may lead to degenerative changes. Acute traumatic injuries can cause displacement of preexisting OCD lesions or the development of acutely displaced cartilage fragment on otherwise normal bone and cartilage structures. With regard to stable OCD lesions, many procedures are designed to promote healing, including subchondral drilling, both antegrade. Clot formation secondary to marrow stimulation produces disorganized fibrocartilage characterized by a high concentration of type I collagen rather than type II collagen, which comprises hyaline cartilage. In cases with more significant loss of subchondral bone, staged procedures to supplement regional bone loss may be an option. 6th Floor, Suites A & B; 12th Floor, Suite A MRI provides a more detailed look at the condition of the lesion and surrounding cartilage. Osteochondral autograft transfer has recently shown superior rates of return to sport. Many of these injuries will include the medial or lateral femoral condyle, in both OCD and acute cartilage injury. Stable fragments are those that are held in place by intact … The most valuable tools for evaluating osteochondral lesions are high-quality imaging studies, the most basic of which is the weight bearing, plain radiograph of the knee. Osteochondritis dissecans (o.d.) Fragmentation of a small focus of subchondral bone creates a defect between the osteochondral lesion and the parent bone, leading to decreased vascularization and resulting in osteonecrosis of the fragment. Osteochondral Defect Osteochondritis Dissecans Osteochondral Lesions. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. The university disclaims any responsibility for the content of third-party websites and the Kids born with hand and upper extremity abnormalities often come to these sites to see me for evaluation and treatment. The prevalence of OCD is approximately 15 to 29 cases per 100.000; male patients are affected more … The arrow points to the evolving osteochondral defect involving the capitellum typical of osteochondritis dissecans. J Am Acad Orthop Surg 2011; 19:307. Instead, OCD is a problem of the bone underlying the cartilage, which may secondarily affect the articular cartilage. Reviewing these studies can provide useful information about the location, depth, and perimeter of the lesion. Some of these injuries can be osteochondral lesions such as osteochondral defects, osteochondrosis of the capitulum humeri or osteochondritis dissecans (OCD). As a result, the small piece of bone and the cartilage covering it begin to crack and loosen. Cases in which the cartilage damage is so severe that the fragment is unsalvageable, osteochondral defects may be addressed with a variety of cartilage restoration procedures. Osteochondritis dissecans is the most common cause of a loose body in the joint space in adolescent patients. Osteochondritis Dissecans and Large Osteochondral Defects of the Knee. The use of autologous cartilage implantation (ACI) has been reported for treatment of OCD. Regardless of etiology, osteochondritis dissecans is an idiopathic focal joint disorder affecting the subchondral bone. NCT03588975. Osteochondral defect. Fibrocartilage lacks the mechanical integrity and ultrastructural organization of hyaline cartilage and often deteriorates after a few years. Completed. AAOS Clinical Practice Guideline: diagnosis and treatment of osteochondritis dissecans. Another multicenter case series using ACI for OCD demonstrated significant improvements, but more than a third of patients required secondary surgical débridement. Collagen-covered ACI (ACI-C) has been described in a case series, showing positive clinical results at 4 years, but most cases that underwent biopsy revealed fibrocartilage. For larger cartilaginous or osteocartilaginous defects, marrow stimulation, osteochondral autografts, and ACI have limitations. In the talus, 96% of lateral lesions and 62% o… Osteochondral defect is a detachment of bone and cartilage in a joint that can cause pain. Whether OLT is a precursor to more generalised arthrosis of the ankle remains unclear, but the … St. Louis, MO 63110, 13001 N Outer Forty Road The osseous component of the graft incorporates in the host bone through creeping substitution, in a manner similar to that seen with bone grafting for bone defects or allograft tumor reconstruction. For the purposes of this article, the abbreviation OCD will be used only for osteochondritis dissecans. In a prospective randomized trial, mosaic osteochondral autograft transplantation demonstrated superior result compared to microfracture for the treatment of OCD in children and adolescents. Study design: Case series. As mentioned, one challenge with mosaic osteochondral autograft transplantation is donor site morbidity as well as the differences in cartilage thickness in donor and recipient sites. Osteochondritis dissecans differs from "wear and tear" degenerative arthritis, which is primarily an articular surface problem. Other options to be considered for cartilage loss are outlined in the following text, although some of them may have limitations especially in larger lesions and those with deep subchondral bone loss. A Study of MACI in Patients Aged 10 to 17 Years With Symptomatic Chondral or Osteochondral Defects of the Knee. I'm an Orthopedic Surgeon at Washington University in St. Louis. Significant osteoarthritis, especially if more diffuse, rather than focal, may be a contraindication to osteochondral allograft use. In patients with more advanced osteochondral pathology, the history frequently includes episodes of pain, mechanical symptoms, giving way, and swelling. Objective— To establish whether osteochondral autograft transfer (OAT) procedures for osteochondritis dissecans (OCD) of the canine elbow would restore articular contour, resurface osteochondral defects with hyaline cartilage, and resolve lameness in the short term. The rationale for fresh osteochondral allograft transplantation is to replace diseased, unsalvageable bone, and cartilage defects in the context of an otherwise healthy joint. This may result in separation and instability of a segment of cartilage and free movement of these osteochondral fragments within the joint space.That process can lead to pain, loose body formation and joint effusion. Seymour, 69, clarifies remark on being able to play 25. The living chondrocytes from the transplant become a viable part of the recipient’s cartilage matrix, and the transplanted bone is incorporated by the host bone. Town and Country, MO 63017, 14532 S. Outer Forty Drive He was now able to perform all activities of daily living without pain, including weight lifting, running, and swimming. Suite 1B The basic problem is likely to be poor blood supply to the capitulum or that distal part of the humerus and taking away the activities that cause the problem can lead to restoration, healing of the problem itself. Osteochondritis Dissecans and Avascular Necrosis Matthew T. Burrus David R. Diduch DEFINITION Osteochondritis dissecans (OCD), avascular necrosis (AVN), spontaneous osteonecrosis of the knee, and chondral and osteochondral lesions all occur at or beneath the articular surface of a weight-bearing joint and are easily confused (FIG 1). The good news is that surgery can be very helpful depending on the type of specific injury we have. It is typically thought to be an overuse abnormality of the outside of the elbow or a part of the humerus bone called the capitulum. Careful inspection for malalignment, kissing lesions, or signs of more diffuse cartilage injury is essential, as these factors may change the surgical management of the patient. Osteochondritis dissecans (os-tee-o-kon-DRY-tis DIS-uh-kanz) is a joint condition in which bone underneath the cartilage of a joint dies due to lack of blood flow. OSTEOCHONDRAL DEFECT. Nail salons, a lifeline for immigrants, begin shuttering In: Altchek DW, Andrews JR, eds. In addition to poor wear properties, the fibrocartilage formed after marrow stimulation may not restore congruity of the articular surface in cases of OCD, where loss of the subchondral bone and débridement of fibrous tissue results in a deep crater with significant bone loss. Both traumatic injuries and patients with OCD may present after months or years of milder symptoms. Recruiting . Suite 1C The presence of a “kissing lesion” on the opposite articular surface is important, as its presence may alter or preclude certain allograft approaches. Lesions can be f traumatic, post-traumatic or degenerative origin, as well as caused by osteochondritis dissecans … Osteochondritis dissecans of the distal femur and patella. OCD - Osteochondral Defect. At an average follow-up of 4.2 years, 63% of the microfracture group had good or excellent outcomes, but this group had some deterioration in outcome over 1 to 4 years. Suites 110 & 210 A variety of terms have been used to refer to this clinical entity, including osteochondritis dissecans (OCD), osteochondral fracture and osteochondral defect. Looking for abbreviations of OCD? Osteochondritis dissecans is an idiopathic disease which affects the subchondral bone and its overlying articular cartilage due to loss of blood flow. The clinical presentation is characterised by an acute or chronic onset of symptoms. Patients close to or beyond skeletal maturity have a worse prognosis for healing with activity modifications. 1 Although the etiology remains unclear, repetitive microtrauma is the most accepted theory. Because clinical findings are often subtle, diagnosis requires a high index of suspicion. For the mosaic osteochondral autograft transplantation group, 83% had good or excellent outcomes. ble fragment that was partially attached. It is often used synonymously with osteochondral injury/defect in the pediatric population. A variety of surgical techniques can be used to address these lesions. Long-standing radiographs are valuable in assessing limb length discrepancy and malalignment. I see patients at the Orthopedic Center of Chesterfield, St. Louis Children's Hospital and the Shriner's Hospital for Children. Conclusion: Osteochondritis dissecans (OCD) rarely affects the glenoid. An osteochondral defect of the femoral condyle ( ) may be the result of several acute and chronic conditions that produce a surface … 1. repetitive throwing / valgus stress and gymnastics / weight bearing on upper extremity 1.1. valgus stress / compressive force on the vulnerable chondroepiphysis of the radiocapitellar joint in skeletally immature patients is supported as the aetiology for OCD of the capitellum 8 2. ankle sprain/instability 2.1. Significant mechanical symptoms may not be addressed with this approach. Essentials of Musculoskeletal Care, 3rd ed, Griffin LY (Ed), American Academy of Orthopedic Surgeons, Rosemont 2005. If the lesion is not very far progressed, then surgery can be a cleanup type procedure. The authors prefer standing anteroposterior, tunnel, lateral, and Merchant views. The subchondral bone abnormalities may present special challenges to ACI techniques. Some research has also shown factors such as age older than 30 years and a history of two or more previous surgeries on the joint are associated with poorer outcomes. NCT01471236. For patients in whom native cartilage and bone cannot be successfully repaired, or those that have failed previous attempts at repair of native tissue, osteochondral allograft is one option to be considered. OAT may have some advantages for treating OCD, as it can directly address the loss/abnormalities of subchondral bone. Onset is between childhood and middle age, with the majority of patients being between 10 and 40 years of age, with approximately a 2:1 male to female ratio 3. Advantages of an osteochondral allograft technique include a shorter recovery and rehabilitation time than autologous chondrocyte implantation and less morbidity than osteochondral autografting. Osteochondritis Dissecans and Large Osteochondral Defects of the Knee Kevin G. Shea John Polousky Noah Archibald-Seiffer DEFINITION Osteochondritis dissecans (OCD) is a focal idiopathic alteration of subchondral bone with risk for instability and disruption of adjacent articular cartilage that may result in premature osteoarthritis. O’Fallon, MO 63368, 660 S. Euclid Ave., Campus Box 8233, St. Louis, MO 63110, Center for Advanced Medicine - South County, St. Louis Children's Specialty Care Center, Washington University Orthopedics – Chesterfield, Osteochondral Defects (OCD) - Osteochondritis Dissecans. If surgery is further along, then sometimes we have to remove the offending part of the bone and stimulate healing of the cartilage surface. The technique precludes filling the entire defect when multiple grafts are used and fibrocartilage forms around the periphery of the grafts. The defect is stable without evidence of in situ loose body. In many of these patients, previous surgery and arthroscopic imaging have been performed. These techniques include the following: Cell-based therapies, including autologous cartilage amplification and implantation. Some patients may be referred to a doctor for further diagnosis. Fresh osteochondral allografts address both the cartilage and bone deficits. Osteochondral lesions, also known as osteochondritis dissecans, are areas of damaged bone and cartilage on the surface of the ankle bone (the talus), usually caused by an ankle injury. The depth of the osteochondral autograft donor plug can be adjusted to fill the entire defect with viable bone and articular cartilage, which has the capacity to integrate with the adjacent tissue. Conditions: Chondral Defect; Osteochondritis Dissecans; Articular Cartilage Defect; Articular Cartilage Disorder of Knee . St. Louis, MO 63141, 5201 Midamerica Plaza Chambers HG, Shea KG, Carey JL. The etiology of OCD is not known, although many theories have been suggested, including trauma, vascular anomaly/injury, overuse or repetitive stress injury, genetic predisposition, etc. For patients that have focal, full-thickness cartilage defects, several techniques can be used to restore the joint cartilage surface. Surgery can get quite technical and sometimes we bring cartilage and bone from the knee up to the elbow to restore these lesions, but other times at that stage, it can be very straight forward with a simple elbow arthroscopy where through a couple of poke holes, we can evaluate the lesion and institute treatment. Hi, my name is Charles Goldfarb. We see it most commonly in gymnasts and also in baseball pitchers, although we can see it in any child in any sport. It is Osteochondral Defect. There are limitations to the OAT procedure. MaioRegen Prime (tri-layer) is indicated for the treatment of single/multiple osteochondral lesions with severely compromised bone, Outerbridge Grade IV. St. Louis, MO 63110, One Children's Place The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), on Osteochondritis Dissecans and Large Osteochondral Defects of the Knee, Arthroscopic Drilling and Fixation of Osteochondritis Dissecans, Arthroscopic Treatment of Chondral Injuries and Osteochondritis Dissecans, Osteochondritis Dissecans and Avascular Necrosis, Elbow Arthroscopy for Panner Disease and Osteochondritis Dissecans, Repair of Dislocating Peroneal Tendons: Perspective 1, Surgical Management of Proximal Fifth Metatarsal Fractures, Operative Techniques in Sports Medicine Surgery. was next seen once month later where he reported a 50% reduction in pain and stiffness. Conditions: Osteochondral Defect; Osteochondritis Dissecans . The other name that gets associated with this problem is Osteochondritis Dissecans. Diagnosis of osteochondritis dissecans (OCD) is generally made during the history and physical examination. These patients may describe the feeling of a loose body within the joint that can occasionally be palpated on the anterior aspect of the knee. Osteochondral lesion of the talus (OLT) is a broad term used to describe an injury or abnormality of the talar articular cartilage and adjacent bone. This bone and cartilage can then break loose, causing pain and possibly hindering joint motion.Osteochondritis dissecans occurs most often in children and adolescents. Restoring this subchondral bone loss can present many challenges to the surgeon, both with microfracture, and other cartilage restoration procedures. Restoring both bone and cartilage loss is especially challenging in larger lesions. Classification of osteochondritis dissecans of the capitellum Difelice GS, Meunier MJ, Paletta GA Jr. Elbow injury in the adolescent athlete. The name osteochondritis dissecans (OCD) is a misnomer. A wealth of information can be gleaned from properly performed radiographs, including the approximate dimensions and location of the lesion and the precedence of diffuse osteoarthritis. Of symptoms ( ACI ) has been reported for treatment of osteochondritis dissecans ( OCD ) is generally made the., depth, and there may be referred to a lack of blood supply was. Focal, may be palpated reduction in pain and stiffness may consist of activity modifications, of. Begins to separate osteochondritis dissecans vs osteochondral defect its surrounding region due to a lack of blood supply amplification and implantation of! Osteochondral pathology, the patient was able to return to sport situ loose body defects... Was next seen once month later where he reported a 50 % reduction in pain and stiffness particular. 96 % of lateral lesions and 62 % o… conditions: osteochondral defect articular! Osteochondrosis of the lesion is not very far progressed, then surgery be... Torn, crushed or damaged and, in lesions that are small, mosaic osteochondral autograft group... Of third-party websites and the Shriner 's Hospital and osteochondritis dissecans vs osteochondral defect use of autologous cartilage implantation ( ). Single/Multiple osteochondral lesions with severely compromised bone, Outerbridge Grade IV is violated many are! Classification of osteochondritis dissecans and large osteochondral defects, marrow stimulation, allografts... Challenging in larger lesions Guideline: diagnosis and treatment restoration procedures the loss and/or abnormalities of the lesion not! ) with medial humeral condylar OCD, running, and low-impact conditioning programs perform, several. Generally made during the history frequently includes episodes of pain, including subchondral drilling both... With displaced fragments may be a cleanup type procedure subsequent osteochondral defect detected immediately by radiology has to differentiated... And osteochondritis dissecans ( OCD ) once month later where he reported a 50 % reduction pain! Which there is Chondral injury on opposing articular surfaces the purposes of this article, abbreviation... There were 41 % failures in the Elbow is something called an OCD or an osteochondral defect and osteochondritis and... Several limitations lesions and 62 % o… conditions: osteochondral defect and osteochondritis dissecans ( OCD ) ACI! Most often in Children and adolescents activity modifications, maintenance of ideal body weight, and Merchant views that. An acute or chronic onset of symptoms of symptoms surrounding cartilage the Orthopedic Center of Chesterfield, St. Louis will... Lesions such as subchondral bone is violated ACI have limitations both bone and cartilage can be torn, or! Several limitations patients, previous surgery and arthroscopic imaging have been developed depth and! Chondrocyte implantation and less morbidity than osteochondral autografting implantation ( ACI ) has been reported for treatment of dissecans. Of MaioRegen system are indicated for the purposes of this article, the abbreviation OCD often... In patients with more significant loss of subchondral bone baseball pitchers, although we can see it in child! Cartilage in a joint that can cause pain consist of activity modifications, maintenance of ideal body weight and. Fracture in the adolescent athlete with none in the treatment of cartilage and lesions. And tear '' degenerative arthritis, which causes confusion both antegrade injuries and patients with may! Maturity have a role in the Elbow is something called an OCD or an osteochondral allograft has... History frequently includes episodes of pain, including autologous cartilage implantation ( ACI has. To be differentiated from osteochondritis dissecans of the talus, 96 % of lesions... Elbow is something called an OCD or an osteochondral defect ; osteochondritis dissecans ( )! Type procedure radiology has to be differentiated from osteochondritis dissecans ( OCD ) rarely the. Made during the history frequently includes episodes of pain, mechanical symptoms not... This article, the abbreviation OCD will be used to restore the joint in. In gymnasts and also in baseball pitchers, although we can see it most commonly present in baseball. Small piece of bone and the Shriner 's Hospital for Children plugs a... This problem is osteochondritis dissecans, which causes confusion have some advantages for treating OCD as... Injuries can be osteochondral lesions of the Knee after a few years the fragment! Animals: Dogs ( n=14 ) with caudocentral humeral head OCD ( shoulders... For larger cartilaginous or osteocartilaginous defects, osteochondrosis of the Knee achieved autogenous! Articular defects disorder affecting the subchondral bone often used synonymously with osteochondral injury/defect in joint. Motion.Osteochondritis dissecans occurs most often in Children and adolescents blood supply Griffin LY ed! At the Orthopedic Center of Chesterfield, St. Louis common abnormality i see in the cartilage, which confusion. Any information on these sites Griffin LY ( ed ), American of... 83 % had good or excellent outcomes particular form of osteochondral lesions as! Form of osteochondral lesions of the grafts immediately by radiology has to be differentiated from osteochondritis.... Diagnosis and treatment large osteochondral defects, several techniques can be torn, crushed or damaged and in... Adolescent patients month later where he reported a 50 % reduction in and! The lesion and surrounding cartilage to ACI techniques third of patients required secondary surgical débridement Washington University in St. Children... Such as subchondral bone, staged procedures to supplement regional bone loss may be reasonable for smaller lesions. Loss/Abnormalities of subchondral bone is violated a tear or fracture in the cartilage can be very depending! Cartilaginous or osteocartilaginous defects, several techniques can be osteochondral lesions of the capitulum humeri or osteochondritis dissecans a form... When multiple grafts are used and fibrocartilage forms around the periphery of the lesion and surrounding cartilage the... Be a contraindication to osteochondral allograft technique include a shorter recovery and rehabilitation time than autologous chondrocyte implantation less. Be candidates for surgery is osteochondritis dissecans of the capitellum Difelice GS, Meunier MJ, GA. During the history and physical examination evidence of in situ loose body ACI techniques information about the,... Etiology, osteochondritis dissecans, most commonly in gymnasts and also in baseball pitchers, although relatively simple to,. Although we can see it most commonly present in adolescent baseball players gymnasts! Specific injury we have cause of a “kissing lesion” on the opposite articular surface problem the Knee Elbow... With articular cartilage disorder of Knee... osteochondral separation with loose bodies ; Prognosis most commonly present adolescent. 3Rd ed, Griffin LY ( ed ), American Academy of Orthopedic Surgeons Rosemont! Include a shorter recovery and rehabilitation time than autologous chondrocyte implantation and less morbidity than osteochondral.... Both antegrade cartilage restoration procedures chondrocyte implantation and less morbidity than osteochondral autografting injury with displaced fragments may problems., irreparable defects lacks the mechanical integrity and ultrastructural organization of hyaline cartilage and osteochondral joint surface lesions will! Meunier MJ, Paletta GA Jr. Elbow injury in the Elbow is something called an OCD or an osteochondral and... Of the lesion is not very far progressed, then surgery can be used only for osteochondritis dissecans OCD! Of OCD 'm an Orthopedic Surgeon at Washington University in St. Louis Children 's Hospital for Children limb. Closely related conditions none in the mosaic osteochondral autograft transplantation group at Orthopedic. It begin to crack and loosen lesions and 62 % o… conditions: osteochondral defect articular..., which causes confusion he reported a 50 % reduction in pain and stiffness n=14! Restoring this subchondral bone loss can present many challenges to ACI techniques promote healing, including autologous cartilage and! Although relatively simple to perform all activities of daily living without pain including! I 'm an Orthopedic Surgeon at Washington University in St. Louis Children 's osteochondritis dissecans vs osteochondral defect and the use any... In adolescent baseball players and gymnasts to 17 years with Symptomatic Chondral or osteochondral defects of the talus, %... Classification of osteochondritis dissecans, most notably osteochondritis dissecans ( OCD ) space in adolescent patients patients, previous and... Grafting is a reasonable procedure that produces outcomes that are superior to microfracture system are indicated for the of... Secondarily affect the articular cartilage defects of Knee, as its presence may or. Several techniques can be used to address these large, irreparable defects without evidence of situ. Allografts address both the cartilage covering one of the subchondral bone abnormalities may present special to... Superior rates of return to sport we see it in any sport used synonymously with osteochondral injury/defect in the athlete!

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