Osteochondritis Dissecans Lesions of the Knee: Evidence-Based Treatment.
| Autor: | Nammour MA; From the Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center- Shreveport, Shreveport, LA (Nammour), Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA (Mauro, Bradley and Arner)., Mauro CS, Bradley JP, Arner JW |
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| Jazyk: | angličtina |
| Zdroj: | The Journal of the American Academy of Orthopaedic Surgeons [J Am Acad Orthop Surg] 2024 Jul 01; Vol. 32 (13), pp. 587-596. Date of Electronic Publication: 2024 Jan 30. |
| DOI: | 10.5435/JAAOS-D-23-00494 |
| Abstrakt: | Osteochondritis dissecans (OCD) of the knee is a potentially disabling condition in adolescent and young adults, which is likely multifactorial in origin. In recent years, there have been notable improvements in identification and treatment. Clinical presentation varies based mostly on OCD lesion stability. Patients with stable lesions generally present with vague knee pain and altered gait while mechanical symptoms and effusion are more common with unstable lesions. Lesions most commonly occur on the lateral aspect of the medial femoral condyle in patients aged 10 to 20 years. Magnetic resonance imaging is vital to diagnose and predict clinical treatment, which is largely based on stability of the fragment. Conservative treatment of stable lesions in patients with open physis is recommended with protected weight-bearing and gradual progression of activities over the course of 3 to 6 months. Stable OCD lesions which failed a nonsurgical course can be treated with transarticular or retrograde drilling while unstable lesions usually require fixation, autologous chondrocyte implantation (ACI), osteochondral autograft transfer (OATS), or osteochondral allograft transplantation. This review highlights the most current understanding of knee OCD lesions and treatment options with the goal of optimizing outcomes in this difficult pathology. (Copyright © 2024 by the American Academy of Orthopaedic Surgeons.) |
| Databáze: | MEDLINE |
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