osteochondritis dissecans

Harvest site

Option 1

- lateral and medial aspect femoral trochlea

Option 2

- intercondylar notch

Option 3

- allograft

- can take larger grafts without donor site risk

Size

NHx

European Orthopaedic Paediatric Study JPO 1999

- 452 patients

- juvenile and adult

Findings

- stable lesion with cartilage intact and no dissection had good prognosis

- if signs dissection, surgical management better than non surgical

- sclerosis on x-ray poor prognostic sign

- lesions > 2cm poor prognosis

- 20% OCD in juveniles abnormal x-ray findings at 3 years (not benign process)

Epidemiology

Adolescents & young adults

Usually between 12 - 21 years 

Throwing athletes / gymnasts

Little Leaguer's Elbow

- combination of capitellar OCD and MCL injury

- a repetitive throwing injury / seen in pitchers

Aetiology

1.  Trauma & Overuse

Common throwing sports / gymnastics

Definition

Osteochondritis Dissecans

- separation of avascular fragment of bone & cartilage

Epidemiology

M : F = 2:1

Mean age 18 years

- can present as young as 9

4:1000

Definition

Fracture talus through articular cartilage into subchondral bone

- 2° force transmitted from distal tibia

Osteochondritis dissecans v osteochondral fracture

Epidemiology

6% ankle sprains

Average age = 25 

M > F

Location