Cahill BR. Crossref, Medline, Google Scholar; 27 De Smet AA, Ilahi OA, Graf BK. Endogenous and exogenous traumas play a minor role in the etiology of this disorder. Keywords: juvenile osteochondritis dissecans; knee joint; paediatric Cite this article: EFORT Open Rev 2019;4:201-212. No one knows exactly why JOCD occurs. This bone and cartilage can then break loose, causing pain and possibly hindering joint motion.Osteochondritis dissecans occurs most often in children and adolescents. Thus, accurate and timely diagnosis followed by appropriate management is essential when dealing with juvenile osteochondritis dissecans. Osteochondritis dissecans (OCD) of the knee is a disease of the subchondral bone with secondary injury to the overlying articular cartilage. This will open a new window. Magnetic resonance imaging confirmed an osteochondritis dissecans lesion of the medial femoral condyle, and the patient was diagnosed with stage I juvenile osteochondritis dissecans of the knee. Juvenile osteochondritis dissecans (JOCD) is a condition in which a portion of subchondral bone and its overlying cartilage become damaged; it usually affects the knee. Treatment depends on many factors. JOCD occurs most frequently in children who are athletically active between the age of ten and 20, with a mean age of 13.4 years at diagnosis [1, 2]. JOCD usually occurs in active children and young adolescents. NCT04297449. We know that is more likely to occur in young people who are very active. An ideal treatment strategy with an optimal surgical technique to repair the osteochondral lesions in these patients is still controversial. Die Osteochondrosis dissecans (kurz OCD bzw. OCD and JOCD cause the same kind of damage to the knee, but they are separate diseases. OD, angloamerikanisch auch Osteochondritis dissecans) ist eine umschriebene Knochenläsion unterhalb des Gelenkknorpels, die mit der Abstoßung des betroffenen Knochenareals mit dem darüberliegenden Knorpel als freier Gelenkkörper (Gelenkmaus) enden kann. Anterior Knee Pain; Chondral Defect of the Knee; Effects of a Partial Meniscectomy on Articular Cartilage; Knee Arthritis; Osteochondritis Dissecans of the Knee; Osteoarthritis of the Knee; Risk of Osteoarthritis After ACL Surgery; Complex Knee Injuries. Of 73 patients in whom 122 lesions of osteochondritis dissecans of the knee developed, nearly half had multiple lesions and 30% were of short stature. A joint is where two bones come together. It belongs to the aseptic bone necrosis and is potentially reversible. With the knee fully flexed, it should be possible to palp… Not yet recruiting. Excellent short-term results have been reported with these techniques, although long-term data are lacking regarding the future development of osteoarthritis in this young patient population. Osteochondritis Dissecans Osteochronditis dissecans (aka “OCD”) is a condition in which the bone that supports the cartilage inside a joint undergoes softening. Keywords: juvenile osteochondritis dissecans; knee joint; paediatric Cite this article: EFORT Open Rev 2019;4:201-212. Crossref, Medline, Google Scholar; 27 De Smet AA, Ilahi OA, Graf BK. In many cases of OCD in children, the affected bone and cartilage heal on their own, especially if a child is still growing. Juvenile Osteochondritis Dissecans is a condition of the joint surfaces and underlying bone that occurs in people who are still growing. OCD and JOCD cause the same kind of damage to the knee, but they are separate diseases. It mostly affects the femoral condyles, especially the medial condyle on the lateral joint … This will open a new window. This area carries the least weight. But the disease behaves much differently in children and for this reason is given a separate name, juvenile osteochondritis dissecans (JOCD), meaning osteochondritis dissecans of children. Changes in the cartilage and underlying bone lead to pain, alterations in movement and ability to compete in their sport. Osteochondritis dissecans (OCD) of the knee is a common cause of pain in both juveniles and adults. It is thought to be related to overuse and classically occurs at the posterolateral aspect of the medial femoral condyle. An MRI (magnetic resonance imaging test) may also be necessary for further evaluation. It mostly affects the femoral condyles, especially the medial condyle on the lateral joint surface (±80%). OCD usually causes pain and swelling of the affected joint which catches and locks during movement. Psychological Response and Readiness Associated With OCD of the Knee. He termed the condition quiet necrosis. (OBQ11.274) Which area of the knee is most likely to be affected by a juvenile osteochondritis dissecans (JOCD) lesion? For this The prognosis depends on several factors. In the adult, the bones are not growing. The condition can be mild, moderate, or severe. Tested Concept QID: 3697 Juvenile Osteochondritis Dissecans. Typically seen in children and young people, JOCD is primarily an active youth person’s condition. With JOCD, there is a loosening of a piece of bone and the cartilage that covers it. Osteochondritis dissecans (OCD or OD) is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone. X-rays may show small pieces of bone which have separated. * This results in a spectrum of pathology beginning with a lesion to the bone only, followed by eventual cartilage separation, bone separation, and loose body formation. Unfortunately, JOCD often requires a long period of rest from sports to allow for healing. The time until return-to-sports is different for each child. Es verbleibt dann ein Gelenkflächendefekt (Mausbett). Osteochondritis dissecans occurs most often in children and adolescents. JUVENILE OSTEOCHONDRITIS DISSECANS OF KNEE e1005. Copyright © 2020 Elsevier B.V. or its licensors or contributors. Although juvenile-type OCD lesions typically appear stable on superficial examination, conservative treatment results in cure in approximate 50% of patients. Copyright © 2008 Elsevier Inc. All rights reserved. given a separate name, juvenile osteochondritis dissecans (JOCD), meaning osteochondritis dissecans of children. While the prevalence of OCD ranges from 15 to 29 per 100,000 individuals [ 29 , 36 ], the incidence may be increasing due to greater detection … Osteochondritis dissecans can be split into a juvenile form (JOCD) and an adult form (OCD). Final radiographs are then obtained to ensure complete decompression of the OCD lesion (Fig 6). Juvenile Osteochondritis Dissecans Juvenile Osteochondritis Dissecans (JOCD) is a disorder which occurs in young people whose growth plates haven’t closed yet. In the talus, 96% of lateral lesions and 62% of … This bone and cartilage can then break loose, causing pain and possibly hindering joint motion. The etiology is ultimately unclear. Correlation of magnetic resonance imaging to arthroscopic findings of stability in juvenile osteochondritis dissecans. 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. Of 73 patients in whom 122 lesions of osteochondritis dissecans of the knee developed, nearly half had multiple lesions and 30% were of short stature. OCD of the knee is often subcategorised into juvenile osteochondritis dissecans (JOCD) and adult OCD. The condition can be mild, moderate, or severe. Operative intervention is reserved for stable lesions that do not heal after 6 to 9 months of conservative management, for large stable lesions in children approaching skeletal maturity, and for most unstable lesions. This softening is caused by an interruption in the blood flow to that portion of the bone. Psychological Response and Readiness Associated With OCD of the Knee. Osteochondritis dissecans (OCD) includes a spectrum of joint disease involving articular cartilage, 1,6,12,26 with the subchondral bone lesion having the potential to progress to varying degrees of osseous resorption, collapse, detachment, and violation of the overlying articular cartilage, which may result in intra-articular loose body formation. The osteochondritis dissecans (OCD) is a disease of the subchondral bone with involvement of the overlying cartilage. Stanley Manne Children's Research Institute has moved onto the campus of its medical partners creating the promise of greater impact for pediatric research. It belongs to the aseptic bone necrosis and is potentially reversible. Conservative management by a physical therapist was the recommended treatment, and after 6 months, the patient no longer complained of left knee pain, and repeat knee radiographs demonstrated … Osteochondritis dissecans (OCD) is a pathological process affecting the subchondral bone (most often in the knee joint) of children and adolescents with open growth plates (juvenile OCD) and young adults with closed growth plates (adult OCD). This video discusses the assessment, diagnosis and treatment of juvenile osteochondritis dissecans of the knee. Research at Lurie Children’s is conducted through Stanley Manne Children's Research Institute. In 10% of the cases it is located on the patella. DOI: 10.1302/2058-5241.4.180079 Introduction Osteochondritis dissecans (OCD) is an acquired condition of the joint that affects the articular surface and the sub-chondral bone. While the prevalence of OCD ranges from 15 to 29 per 100,000 individuals [ 29 , 36 ], the incidence may be increasing due to greater detection … In 50% of cases, juvenile osteochondritis dissecans lesions of the knee will heal within 10 to 18 months in the compliant patient. JUVENILE OSTEOCHONDRITIS DISSECANS OF KNEE e1005. Other cartilage repair techniques may be used for failures of the previously described treatment. Typically seen in children and young people, JOCD is primarily an active youth person’s condition. There are two main places in the knee joint where osteochondritis dissecans can appear. Download a PDF version of this information. Typically, the skeletally immature patient initially is treated nonoperatively and has a better overall outcome. 1. Juvenile versus adult osteochondritis dissecans of the knee: appropriate MR imaging criteria for instability. Internal fixation is added for larger or unstable lesions. Damaged and unsalvageable jOCD lesions or displaced jOCD lesions devoid of subchondral bone are generally treated initially with debridement and abrasion arthroplasty (microfracture). Your physician will provide you with guidelines about a gradual return to activities after treatment. In the child who is still growing, the problem is much more likely to heal itself. curved curette to more accurately remove the remainder of the OCD (Fig 5). Radiology. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. Juvenile Osteochondritis Dissecans of the Knee. Joint effusion is often present, particularly if there has been trauma. Conditions: Osteochondritis Dissecans; Juvenile Osteochondritis Dissecans . Osteochondritis dissecans (OCD) should be considered in young, active patients who have generalized or anterior knee pain. Endogenous and exogenous traumas play a minor role in the etiology of this disorder. One such diagnosis is juvenile osteochondritis dissecans of the knee, a condition that commonly affects athletic children, and one that if left unchecked could jeopardise the integrity of their knee. NCT04649905. The condition happens most often in the knees… Most children with JOCD do very well in the long-term. ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. This classically occurs on the lateral aspect of the medial femoral condyle. 3. Your physician will often recommend bracing or casting during this rest period. But parents should be warned there is a high risk of failure with no healing possible. Osteochondritis dissecans (OCD) is an acquired, potentially reversible idiopathic disease of subchondral bone resulting in delamination and sequestration. There are two main places in the knee joint where osteochondritis dissecans can appear. Juvenile Osteochondritis Dissecans of the Knee (Updated November 2005) from the Orthopaedic Care Textbook Outcomes of Osteochondral Lesions of the Knee Repaired With a Bioabsorbable Device Categories Joints , Knee Tags Arthroscopy , Knee , Spine , Tibia and Fibula Post navigation Your doctor will carefully examine the affected joint. Children as young as nine or ten can develop this condition. (OBQ11.274) Which area of the knee is most likely to be affected by a juvenile osteochondritis dissecans (JOCD) lesion? Osteochondritis Dissecans of the Knee Dawn L. Swarm MD Robert A. Pedowitz MD, PhD Key Points Traditionally, osteochondritis dissecans (OCD) is divided into juvenile (open physes) and adult (closed physes) formed based on skeletal maturity. Osteochondritis dissecans (OCD) is the end result of the aseptic separation of an osteochondral fragment with the gradual fragmentation of the articular surface and results in an osteochondral defect. 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