Lesions can be f traumatic, post-traumatic or degenerative origin, as well as caused by osteochondritis dissecans … Osteochondritis dissecans of the distal femur and patella. Some small series of clinical applications of this procedure for advanced osteochondritis dissecans of the humeral capitellum, with short-term follow-up, have been reported; however, longer-term outcomes remain unclear. Articular Cartilage Defects of Knee ... osteochondral separation with loose bodies; Prognosis. For the mosaic osteochondral autograft transplantation group, 83% had good or excellent outcomes. It is Osteochondral Defect. Classification of osteochondritis dissecans of the capitellum Difelice GS, Meunier MJ, Paletta GA Jr. Elbow injury in the adolescent athlete. Osteochondral tissue harvested from fresh allograft talus and transplanted into the defect Best for large (>3 cm 2 ) lesions, as an alternative to arthrodesis ( 10 ) 66% success rate ( 11 ) Large defects cannot be filled due to donor site morbidity, and there may be problems with articular cartilage incongruence. Partially detached osteochondral fragment. Another multicenter case series using ACI for OCD demonstrated significant improvements, but more than a third of patients required secondary surgical débridement. The use of a fresh osteochondral allograft for treatment of a lesion of the femoral condyle is relatively new, and we report its use in a unique situation involving identical twins who both presented with osteochondritis dissecans of the same anatomic location within 2 years of each other. Chondral and osteochondral lesions of the humeral capitellum, most notably osteochondritis dissecans, most commonly present in adolescent baseball players and gymnasts. Osteochondral Defect Osteochondritis Dissecans Osteochondral Lesions. Osteochondral lesions, also known as osteochondritis dissecans, are areas of damaged bone and cartilage on the surface of the ankle bone (the talus), usually caused by an ankle injury. Whether OLT is a precursor to more generalised arthrosis of the ankle remains unclear, but the … Careful inspection for malalignment, kissing lesions, or signs of more diffuse cartilage injury is essential, as these factors may change the surgical management of the patient. Consequently, in lesions that are small, mosaic osteochondral autograft transplantation is a reasonable procedure that produces outcomes that are superior to microfracture. In cases with more significant loss of subchondral bone, staged procedures to supplement regional bone loss may be an option. The etiology of OCD is not known, although many theories have been suggested, including trauma, vascular anomaly/injury, overuse or repetitive stress injury, genetic predisposition, etc. Clot formation secondary to marrow stimulation produces disorganized fibrocartilage characterized by a high concentration of type I collagen rather than type II collagen, which comprises hyaline cartilage. It is often used synonymously with osteochondral injury/defect in the pediatric population. Most kids do well when they have this problem although we typically encourage the families to avoid the offending activity so if this seen in a high level gymnast and the elbow doesn't heal fully, that patient may or may not be able to get back to gymnastics as they performed before. For patients that have focal, full-thickness cartilage defects, several techniques can be used to restore the joint cartilage surface. The living chondrocytes from the transplant become a viable part of the recipient’s cartilage matrix, and the transplanted bone is incorporated by the host bone. There were 41% failures in the microfracture group compared with none in the mosaic osteochondral autograft transplantation group at the final follow-up. Osteochondritis dissecans (OCD) is a focal idiopathic alteration of subchondral bone with risk for instability and disruption of adjacent articular cartilage that may result in premature osteoarthritis. The defect is stable without evidence of in situ loose body. J Am Acad Orthop Surg 2011; 19:307. Objective— To establish whether osteochondral autograft transfer (OAT) procedures for osteochondritis dissecans (OCD) of the canine elbow would restore articular contour, resurface osteochondral defects with hyaline cartilage, and resolve lameness in the short term. When I see a child with an OCD of the elbow, we initiate treatment by limiting activities and sometimes simply backing off on gymnastics or baseball may be enough to help control the symptoms and allow the elbow to heal. The clinical presentation is characterised by an acute or chronic onset of symptoms. The good news is that surgery can be very helpful depending on the type of specific injury we have. Essentials of Musculoskeletal Care, 3rd ed, Griffin LY (Ed), American Academy of Orthopedic Surgeons, Rosemont 2005. Fragmentation of a small focus of subchondral bone creates a defect between the osteochondral lesion and the parent bone, leading to decreased vascularization and resulting in osteonecrosis of the fragment. Because clinical findings are often subtle, diagnosis requires a high index of suspicion. 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