Osteochondritis Dissecans - Knee & Sports - Orthobullets

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• pathologic lesion affecting articular cartilage and subchondral bone with variable clinical patterns.

• Diagnosis may be made radiographically (notch view)

• but MRI usually required to determine size and stability of lesion, and to document the degree of cartilage injury.

• Treatment may be nonoperative with restricted weight bearing in children with open physis

• Surgical treatment may be indicated in older patients (closed physis), lesions that are unstable and patients who have failed conservative management.

• juvenile form (open physes)

• occurs at age 10-15 while the physis is still open

• adult form (skeletal maturity)

• knee (most common)

• posterolateral aspect of medial femoral condyle (70% of lesions in knee)

• capitellum of humerus

• talus

• mechanism/etiology may be

• hereditary

• traumatic

• vascular

• cause of adult form is thought to be vascular

• pathoanatomic cascade

• softening of the overlying articular cartilage with intact articular surface

• early articular cartilage separation