In up to 40% of cases, patients give a history of trauma as the inciting event 3. An osteochondral lesion is seen at the posterior weightbearing surface of the medial femoral condyle. Imaging strategies for the knee. 38 (5): 1478-1495. 1994;29 (4): 302-306. This is essential in determining management. His radiographs show an osteochondral defect involving the lateral aspect of his medial femoral condyle (the most common location to see this condition). In the talus, 96% of lateral lesions and 62% of … (1997) The Journal of Bone and Joint Surgery (american Volume). The abnormality is subtle and is best appreciated on the magnified lateral image. Introduction. Scaffolds for Knee Chondral and Osteochondral Defects: Indications for Different Clinical Scenarios. 5. 1 The knee joint is perhaps one of the busiest joints in the body as it bears most of the body weight when standing. (2000) Foot & ankle international. 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. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Osteochondral Injury, Knee ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. The defect may be found on the femoral condyle, tibial plateau, patella, talus, humerus or on other articular surfaces. It is known from long-term followup studies, such as those conducted by Linden, 7 that osteochondritis dissecans diagnosed in adulthood is likely to lead to the development of early onset osteoarthritis. The defect was debrided down to the subchondral bone with an arthroscopic shaver and sized with the osteochondral autograft transplantation system, as shown in Fig. Keywords: Knee, Cartilage, Synovitis, Pigmented villonodular Pigmented villonodular synovitis (PVNS) is a rare, benign, but potentially recurrent condition with an estimated incidence of 1.8 per million. 9. Thieme Publishing Group. (21)Department of Radiology, PennMedicine, Philadelphia, PA, USA. 1. Objective: To identify preoperative imaging-based indicators of knee degeneration that correlate with graft failure risk and postoperative clinical outcome scores after osteochondral graft treatment for chondral defects of the knee. See osteochondritis dissecans article for a general discussion. William Palmer, Laura Bancroft, Fiona Bonar et-al. The abnormality is subtle and is best appreciated on the magnified lateral image. Cause of a “locking knee” Osteochondritis dissecans. Steadman JR, Briggs KK, Rodrigo JJ et-al. A Consensus Statement. For the same photo without the arrows, click here. Red arrows point to osteochondral defect and bone edema on T1 and stir 2A, 2B, 2C, 3A, 3B, and 3C). 7. Osteochondral autograft transplantation surgery was initially conducted in small chondral defects of the knee but has been used in multiple other joints like the hip, ankle, shoulder and elbow in the meantime. Onset is between childhood and young adults age, with the majority of patients being between 10 and 40 years of age, with approximately a 2:1 male to female ratio 3. Early findings include subtle flattening or indistinct radiolucency about the cortical surface. Kocher MS, Tucker R, Ganley TJ et-al. His radiographs show an osteochondral defect involving the lateral aspect of his medial femoral condyle (the most common location to see this condition). Numerous surgical approaches have been tried, including drilling, bone grafting, replacement of bone fragment and pinning 5. ~50% (range 35-70%) of patients achieve a "good to excellent" clinical outcome 3 but even in these cases, the majority develop osteoarthritis. Glossary of terms for musculoskeletal radiology. Bone and joint imaging. Maeurer J. The combined use of standard and newer magnetic resonance (MR) imaging techniques makes it possible to evaluate both the morphologic status and the biochemical contents of the repair tissue (,1–,9). Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management. (2018). The advent of new procedures for repairing cartilage in knee and ankle joints has increased the need for accurate noninvasive methods to objectively evaluate the success of repair. OCD usually causes pain during and after sports. If an osteochondral fragment becomes unstable and displaced, then donor site and intra-articular fragment may be seen. Osteochondral fracture of the lateral femoral condyle is a rare injury of the knee joint, which mostly occurs in adolescence 1.In adolescence, the cartilage‐bone interface is the weakest transitional area in the knee joint, and there is no obvious boundary between calcified and uncalcified cartilage 2.The biomechanical strength of immature osteochondral junction was lower … Other postulated causes include 4: Many joints can be affected, but typical locations include: See osteochondral injury staging and osteochondritis dissecans surgical staging. Large osteochondral defects involving the femoral condyles of the knee have frustrated orthopaedic surgeons for generations. Int Orthop. Lippincott Williams & Wilkins. 14. 12. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. (1955) Acta orthopaedica Scandinavica. 2 article feature images from this case 13 public playlist includes this case CT has the advantage of sectional imaging through the joint and multiplanar reformats. 21 (2): 119-26. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. Epub 2017 Jun 22. 11. Osteochondritis dissecans. ... (20)Department of Radiology, Emek Medical Center, Clalit Healthcare Services, Afula, Israel. (2006) The American journal of sports medicine. As the process progresses, more pronounced contour abnormalities, fragmentation and density changes (both lucency and sclerosis) become evident. It occurs when a small segment of bone begins to crack and separate from its surrounding region due to a lack of blood supply. Osteochondritis dissecans (OCD) is a condition that develops in joints, most often in children and adolescents. 8. J Athl Train. Osteochondritis dissecans of the knee: value of MR imaging in determining lesion stability and the presence of articular cartilage defects. Resnick D, Kransdorf MJ. When surgery is performed, the results in most cases are only "fair". Osteochondritis Dissecans: Etiology, Pathology, and Imaging with a Special Focus on the Knee Joint Cartilage. 13. 4. Osteochondral defect is a term for a localized defect of the articular cartilage and subchondral bone. (2006) ISBN:3131405619. © Copyright These can occur from an acute traumatic injury to the knee or an underlying disorder of the bone. MRI assessment of osteochondral allografts includes evaluation of graft signal intensity, defect fill, cartilage edge integration at host-graft junction, articular surface congruity, subchondral bone plate congruity and bone marrow signal, osseous integration, and presence of cystic changes of graft. Formation ) and controversial, with the majority of cases thought to be result! 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