Database: Ovid MEDLINE(R) <1966 to January Week 3 2004>
Search Strategy:
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1 exp OSTEOCHONDRITIS/ (4914)
2 (knee or akle).af. (52356)
3 1 and 2 (726)
4 exp *OSTEOCHONDRITIS/ and 3 (506)
5 limit 4 to (human and english language) (284)
6 limit 5 to yr=1996-2004 (96)
7 osteochondritis.ti. and 6 (54)
8 6 (96)
9 limit 8 to ovid full text available (10)
10 limit 6 to review (15)
11 9 or 10 (23)
12 7 not 11 (43)
13 from 12 keep 1-2,7,9-10,12-22,24-25,27-28,30-31,33,35,37,39-40,43 (28)
14 from 10 keep 3,6,11-13 (5)
15 10 not 14 (10)
16 9 or 13 or 15 (46)
17 from 16 keep 1-46 (46)
18 from 17 keep 1-46 (46)
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<1>
Unique Identifier
11573913
Authors
Kocher MS. Micheli LJ. Yaniv M. Zurakowski D. Ames A. Adrignolo AA.
Institution
Department of Orthopaedic Surgery, Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
Title
Functional and radiographic outcome of juvenile osteochondritis dissecans of the knee treated with transarticular arthroscopic drilling.
Source
American Journal of Sports Medicine. 29(5):562-6, 2001 Sep-Oct.
Abstract
Management of juvenile osteochondritis dissecans is controversial. The purpose of this study was to evaluate the functional and radiographic outcomes of transarticular arthroscopic drilling for isolated stable, juvenile osteochondritis dissecans lesions of the medial femoral condyle with an intact articular surface after 6 months of nonoperative management had failed. We reviewed 30 affected knees in 23 skeletally immature patients (mean age, 12.3 years; range, 8.5 to 16.1) at an average follow-up of 3.9 years (range, 2.0 to 7.2). Functional outcome was determined using the Lysholm score and radiographic outcome was determined using lesion size, and the radiographic score of Rodegerdts and Gleissner. There was significant improvement in the mean Lysholm score (from 58 to 93). There was significant improvement in the mean lesion size on anteroposterior (4.5 +/- 5.8 mm decrease) and lateral (8.4 +/- 8.1 mm decrease) radiographs. There was also significant improvement in the mean radiographic score (from 3.0 to 1.9). Radiographic healing was achieved in all patients at an average of 4.4 months after drilling (range, 1 to 11 months). Linear regression analysis revealed that younger age was an independent, multivariate predictor of Lysholm score improvement. There were no apparent surgical complications.
<2>
Unique Identifier
9474395
Authors
Paletta GA Jr. Bednarz PA. Stanitski CL. Sandman GA. Stanitski DF. Kottamasu S.
Institution
Department of Orthopaedic Surgery, Children's Hospital of Michigan, Detroit, USA.
Title
The prognostic value of quantitative bone scan in knee osteochondritis dissecans. A preliminary experience.
Source
American Journal of Sports Medicine. 26(1):7-14, 1998 Jan-Feb.
Abstract
We reviewed the records of 12 patients ages 9 to 16 years with knee osteochondritis dissecans. All patients had clinical histories and examinations, four radiographic views of the knee, and technetium-99m diphosphonate quantitative bone scans. Scan results (symmetric, increased, or decreased activity), clinical course, healing time, and final outcome were correlated to determine the prognostic value of the scan. We divided the patients into those with open physes (distal femoral and proximal tibial) and those with closed physes. Four of the six patients with open physes had increased activity on the bone scan. All four of these knees healed with nonsurgical treatment. The other two patients had decreased activity on bone scan, and both required surgical treatment after nonsurgical treatment failed. Of the six patients with closed physes, all had increased activity on the bone scan, but only two patients had healing of the osteochondral lesion without surgery. Quantitative bone scanning had a 100% predictive value for the prognosis in osteochondritis dissecans patients with open physes, but for those with closed physes the predictive value was less. Because the natural history in the adolescent group is less predictable, it is in this group that the quantitative scan would be most helpful. In this small group of patients, quantitative bone scanning had limited prognostic value.
<3>
Unique Identifier
10653545
Authors
Peters TA. McLean ID.
Institution
Prahran Sports Medicine Centre, Victoria, Australia.
Title
Osteochondritis dissecans of the patellofemoral joint.[see comment].
Comments
Comment in: Am J Sports Med. 2001 Jan-Feb;29(1):112-3; PMID: 11206248
Source
American Journal of Sports Medicine. 28(1):63-7, 2000 Jan-Feb.
Abstract
Osteochondritis dissecans of the patellofemoral joint is an uncommon condition that may be the cause of anterior knee pain or crepitus. We present the clinical features of 37 patients with osteochondritis dissecans lesions of the patellofemoral joint (24 on the patella, 13 on the trochlear groove), including two patients with medial trochlear groove lesions, which have not, to our knowledge, been previously reported. The osteochondral lesions involved the convex articular surfaces. The median age of patients when first examined was 15 years, and 54% of patients had open epiphyses. These lesions were more common in male patients than in female patients (four-to-one ratio). Osteochondritis dissecans of the patellofemoral joint can be overlooked unless quality radiographs are viewed with care and, at arthroscopy, both the patella and trochlear groove are assessed. Treatment depends on the symptoms, site, and nature of the lesion and the patient's age. Nonoperative management includes patellar taping and vastus medialis obliquus muscle exercises. Operative intervention is indicated for patients with mechanical symptoms and includes arthroscopy, consisting of chondroplasty and removal of loose bodies, and lateral retinacular release. In this study treatment generally improved the symptoms, but patients with articular cartilage loss had persistent patellofemoral crepitus and discomfort.
<4>
Unique Identifier
12016089
Authors
Yoshizumi Y. Sugita T. Kawamata T. Ohnuma M. Maeda S.
Institution
Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
Title
Cylindrical osteochondral graft for osteochondritis dissecans of the knee: a report of three cases.
Source
American Journal of Sports Medicine. 30(3):441-5, 2002 May-Jun.
<5>
Unique Identifier
11206248
Authors
Smith JS.
Title
Osteochondritis dissecans of the patellofemoral joint.[comment].
Comments
Comment on: Am J Sports Med. 2000 Jan-Feb;28(1):63-7; PMID: 10653545
Source
American Journal of Sports Medicine. 29(1):112-3, 2001 Jan-Feb.
<6>
Unique Identifier
11599758
Authors
Blankstein A. Cohen I. Heim M. Diamant L. Salai M. Chechick A. Ganel A.
Institution
Department of Orthopaedic Surgery, Sheba Medical Center, Tel-Hashomer, Israel.
Title
Ultrasonography as a diagnostic modality in Osgood-Schlatter disease. A clinical study and review of the literature. [Review] [14 refs]
Source
Archives of Orthopaedic & Trauma Surgery. 121(9):536-9, 2001 Oct.
Abstract
Sonographic examination of the knee has been proposed by several authors in the past as a simple and reliable method to diagnose Osgood-Schlatter disease (OSD). Ultrasound was used to compare the knees of 25 boys and 10 girls with typical OSD with 35 symptom-free knees of an aged-matched group of children. Based on recorded data, patients were categorized (one affected knee in each individual) according to the classification system proposed by De Flaviis et al. in 1989. The results included the following pathological findings: pretibial swelling, fragmentation of the ossification center, insertional thickening of the patellar tendon, and excessive fluid collection in the infrapatellar bursa. Of our patients, 26% fell into the type 1 category, 43% were type 2, 20% type 3, and 11% type 4. This distribution of cases was found to be statistically similar to the initial findings reported by De Flaviis and colleagues. This study therefore supports the validity and reproducibility of their classification method for the ultrasonographic evaluation of children with OSD. This is only the first step, and further assessment of this classification is still required to elucidate its clinical as well as its prognostic value. [References: 14]
<7>
Unique Identifier
11536094
Authors
Aglietti P. Ciardullo A. Giron F. Ponteggia F.
Institution
First Orthopaedic Clinic, University of Florence, Florence, Italy.
Title
Results of arthroscopic excision of the fragment in the treatment of osteochondritis dissecans of the knee.
Source
Arthroscopy. 17(7):741-6, 2001 Sep.
Abstract
PURPOSE: To evaluate clinical and radiological results of arthroscopic excision of the fragment and debridement of the crater in the treatment of osteochondritis dissecans of the knee (OCD). Type of Study: Case series. METHODS: We investigated 20 patients with partial or complete detachment of the OCD fragment. The average age at surgery was 21 years (range, 12 to 32 years). All the patients were treated by the same surgeon. They were evaluated at an average follow-up of 9 years (range, 6 to 17 years). RESULTS: The combined subjective and objective evaluation showed excellent and good results for 85% of the patients. Radiographic studies showed 2 grades of worsening (from no degenerative signs preoperatively to narrowing of the joint line up to 50% at follow-up) in 1 patient (5%). One grade of worsening (Fairbank's changes without joint space narrowing) was found in 45% of weight-bearing anteroposterior radiographic views and in 35% of weight-bearing bent knee posteroanterior views. Statistical correlations were significant between radiographic degenerative changes and the size of the osteochondral lesion at surgery, with larger lesions resulting in greater degenerative changes. CONCLUSIONS: The arthroscopic removal of an osteochondral fragment and debridement of the crater is a viable option in the treatment of grade III and IV OCD lesions. Results are better in lesions less than 2 cm(2).
<8>
Unique Identifier
11447548
Authors
Mizuta H. Nakamura E. Otsuka Y. Kudo S. Takagi K.
Institution
Department of Orthopaedic Surgery, Kumamoto University School of Medicine, Kumamoto, Japan.
Title
Osteochondritis dissecans of the lateral femoral condyle following total resection of the discoid lateral meniscus.
Source
Arthroscopy. 17(6):608-12, 2001 Jul.
Abstract
PURPOSE: The purpose of this study was to describe the clinical presentation of 6 athletically active children with symptomatic osteochondritis dissecans (OCD) of the lateral femoral condyle following total resection for a torn discoid lateral meniscus and to discuss its cause. TYPE OF STUDY: Case series. METHODS: Six patients in whom OCD affecting the lateral femoral condyle developed after total resection of the discoid lateral meniscus participated in a detailed clinical, radiologic, and arthroscopic review. The average age at the time of meniscectomy was 9 years (range, 6 to 12 years). At a mean of 50 months (range, 36 to 65 months) after surgery they developed recurrent pain in the treated knee; all had radiologic abnormalities at the lateral femoral condyle consistent with OCD. Before the recurrence of pain, all patients had been continuously engaged in sports activity. Radiologic and arthroscopic findings of the OCD lesions were assessed. Clinical outcomes of surgical treatment for OCD were also documented. RESULTS: The radiographic evaluation showed all lesions to be in the central portion of the lateral femoral condyle on the anteroposterior views and posteriorly next to a line extending distally from the posterior femoral cortex on the lateral views. Arthroscopic evaluation revealed softening in 2 knees, a separated fragment in 2 knees, and a completely loose fragment in 2 knees. All lesions were treated surgically, including 2 drillings of the lesion, 2 fixations of separated fragment, and 2 excisions of loose bodies with drilling. At an average follow-up period of 51 months (range, 22 to 77 months), all patients but 1 were asymptomatic. CONCLUSIONS: Repeated impaction in sports activities on the immature osteochondral structures under altered mechanical force transmission after total resection of the discoid meniscus might be a predisposing factor in the development of OCD in the lateral femoral condyle.
<9>
Unique Identifier
11337726
Authors
Friederichs MG. Greis PE. Burks RT.
Institution
Department of Orthopedics, University of Utah Medical Center, Salt Lake City, Utah, U.S.A.
Title
Pitfalls associated with fixation of osteochondritis dissecans fragments using bioabsorbable screws.
Source
Arthroscopy. 17(5):542-5, 2001 May.
Abstract
The purpose of this study was to evaluate 2 cases in which bioabsorbable screw fixation for an osteochondritis dissecans lesion of the femoral condyle resulted in complications necessitating the need for secondary surgery. We reviewed the case history of these patients and described the circumstances under which the bioabsorbable screws were used, the events leading to the need for secondary surgery, and the ultimate outcome. In the 2 cases presented, these implants were found to retain their mechanical stiffness for many months. This resulted in articular damage in 1 case after the treated lesion failed to heal. In the second case, screw breakage 8 months after implantation resulted in it becoming a loose body, which required removal during a second arthroscopic procedure. We conclude that these implants retain their mechanical properties for many months and cannot be relied on to degrade quickly. If a treated lesion fails to heal, these implants can cause mechanical problems due to their retained structural properties.
<10>
Unique Identifier
11027774
Authors
Kim SJ. Shin SJ.
Institution
Department of Orthopaedic Surgery, Arthroscopic Surgery Unit, Yonsei University College of Medicine, Seoul, Korea.
Title
Loose bodies after arthroscopic osteochondral autograft in osteochondritis dissecans of the knee.
Source
Arthroscopy. 16(7):E16, 2000 Oct.
Abstract
We report a case of loose bodies from the donor site as a complication after the osteochondral autograft for the treatment of osteochondritis dissecans. Eight months after surgery, 3 osteochondral loose fragments, having dislodged from the donor sites of the osteochondral autograft, were found in the posteromedial portion, posterolateral portion, and anterior compartment of the knee, respectively. A large osteochondral defect can be treated successfully with arthroscopic autogenous bone graft. When filling the donor site with the recipient bone core, only the cancellous portion should be inserted into the donor socket.
<11>
Unique Identifier
10231112
Authors
Berlet GC. Mascia A. Miniaci A.
Institution
Department of Surgery, University of Toronto, and The Toronto Western Hospital, Ontario, Canada.
Title
Treatment of unstable osteochondritis dissecans lesions of the knee using autogenous osteochondral grafts (mosaicplasty).
Source
Arthroscopy. 15(3):312-6, 1999 Apr.
Abstract
Symptomatic osteochondritis dissecans lesions with minimal fragmentation that may be replaced within their crater have classically been treated by reattachment. The choice for internal fixation is varied. This article reports on the treatment of unstable osteochondritis dissecans lesions using autogenous osteochondral plugs as a means of biological internal fixation. The appearance on magnetic resonance imaging of osteochondral plugs at 6 and 9 months after transplantation is also presented.