https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTI1MzA3NC10cmVhdG1lbnQ=. The breakdown of the 317 patients was as follows: 192 patients (60.6%) had knee lesions, 85 patients (26.8%) had ankle lesions, 37 patients (11.7%) had elbow lesions, 2 patients (0.6%) had shoulder lesions, and 1 patient (0.3%) had a lesion of the foot. Barrett et al reported that headless metal compression screws, which can be left in place, provide a satisfactory union rate for treatment of unstable osteochondritis dissecans of the femoral condyles in patients who are skeletally mature. There is still incomplete understanding, however, as to what patient factors may correlate with success or failure of conservative management and the frequency of particular procedures. Conservative treatment in these patients includes immobilization of the limb in a cast or brace and no weight bearing for 6-12 weeks. In terms of the breakdown by joint location, progression to surgery for knee OCD was as follows: In the MFC, 37 surgeries were performed out of 131 lesions (28.2%), while in the lateral femoral condyle, 27 surgeries were performed out of 67 lesions (40.3%) (Table 3). Once signs of healing are evident, patients should perform range-of-motion exercises for 20 minutes, 3 times per day. Chi-square analysis was done to determine differences by both age group and sex. Care must be taken to align the fracture before fixing it with Kirschner wires. The knee is the location most often requiring surgery, with 58% of procedures for OCD lesions being performed on the knee. Russell Warren, MD Professor of Surgery, Professor, Division of Orthopedic Surgery, Weill Medical College of Cornell University MRIs showed interval healing in 16 of 17 knees at a mean follow-up of 22.4 months. Osteochondritis dissecans (OCD) is a problem that affects the knee, mostly at the end of the big bone of the thigh (the femur).A joint surface damaged by OCD doesn't heal naturally. Tunnel-view radiograph showing an osteochondral lesion of the medial femoral condyle. While a complete understanding of the factors that predict lesion healing has yet to be elucidated, it has long been noted that patients at or near skeletal maturity show a reduced capacity to heal after fractures or ligamentous injury compared with younger patients. Progression to surgery did not differ significantly between sexes with OCD of any joint. Clin Orthop. In the assessment of procedures performed in the knee, the majority of the surgeries involved chondroplasty/debridement (68.1%), with drilling in 37.1% of lesions. A second periosteal flap is then used for the autologous chondrocyte transplantation, which is performed as previously described. White, non-Hispanic patients were more likely to progress to surgery than patients of “other” ethnicity (P = .0092). An arthroscopic surgery may be done to make small drill holes in the healthier bone around the OCD to improve the blood supply to the OCD piece (fig 3). You can be signed in via any or all of the methods shown below at the same time. Open removal of loose bodies, reconstruction of the crater base, and replacement with fixation yield a success rate of approximately 70%. In terms of sex, males and females were not statistically different in progression to surgery for OCD of any of the individual joints. Signs and Symptoms. This technique is required for extensive defects in which other treatments have failed. †University of Minnesota Medical Center, Minneapolis, Minnesota, USA. Kocher, MS, Czarnecki, JJ, Andersen, JS, Micheli, LJ. About 85 percentof artificial knees still work after 20 years. Plain films at an average of 19.2 months after surgery showed interval healing in 9 patients, no significant change in 1, complete healing in 13, and loose bodies with no interval healing in 1. Siblings of patients undergoing hip and knee replacement surgery have a 2- to 3-fold increased risk of developing OA, with a 27% severe OA heritability rate. Louisia, S, Beaufils, P, Katabi, M, Robert, H. Maruyama, M, Takahara, M, Harada, M, Satake, H, Takagi, M. Mihara, K, Suzuki, K, Makiuchi, D, Nishinaka, N, Yamaguchi, K, Tsutsui, H. Nobuta, S, Ogawa, K, Sato, K, Nakagawa, T, Hatori, M, Itoi, E. Shi, LL, Bae, DS, Kocher, MS, Micheli, LJ, Waters, PM. The lesion may be arthroscopically excised and the crater debrided and drilled to promote vascularity and healing. Osteochondritis dissecans. Knee Osteoarthritis. Weckström M, Parviainen M, Kiuru MJ, Mattila VM, Pihlajamäki HK. Adachi N, Deie M, Nakamae A, Ishikawa M, Motoyama M, Ochi M. Functional and radiographic outcome of stable juvenile osteochondritis dissecans of the knee treated with retroarticular drilling without bone grafting. Bone grafting may be required. The graft is usually harvested from the patient's knee on the same leg, from an area of that joint that does not bear any load. 78(3):439-56. There are a number of treatment options. The literature is quite variable regarding progression to surgery for ankle OCD, with a surgical intervention rate between 19% and 58% in multiple studies.11,21,32 Looking specifically at children, Letts et al32 found a surgical intervention in only 1 of 5 in children under the age of 12 years, Higuera et al21 found a 33% surgical intervention rate in their study of pediatric ankle OCD, and the 20-year follow-up study by Bauer et al11 on ankle OCD in a mixture of children and adults found that only 1 of 5 children had surgery. [Medline]. Choi YS, Cohen NA, Potter HG, Mintz DN. Progression to surgery did not differ significantly between sexes with OCD of any joint, but did strongly correlate with patient age for OCD of the knee, elbow, and ankle. In this large cohort study of pediatric OCD patients, 35% progressed to surgery. 2012 Sep 13. Aetiology of osteochondritis dissecans. The literature is sparse regarding surgical progression of OCD of the elbow. [21]. A prospective, randomised comparison of autologous chondrocyte implantation versus mosaicplasty for osteochondral defects in the knee. i just had surgery on my knee for ocd mine is 2.9cm by 1.8cm the doctor made the same cuts to my knee 2 small ones and one big one half way down my knee its like 2inches long. In a study of juvenile patients with ankle OCD who required surgical intervention, 40% had good results, 53% had fair results, and 7% had poor results. Postoperative images of osteochondritis dissecans are shown below: Following arthroscopic subchondral drilling without debridement or fixation, the affected joint is immobilized and a motion-restricting brace is prescribed. The incidence of OCD has been estimated at between 0.02% and 0.03% based on knee x-rays and adds 1.2% based on knee arthroscopies. [24], Autologous osteochondral mosaicplasty was found to be 94% effective for OCD lesions requiring surgery in the femoral condyle and 88% effective for OCD lesions requiring surgery in the talus. Exclusion criteria included traumatic osteochondral fractures or coexistence of non-OCD intra-articular lesions. Doctor will be required to enter your username and password the next time you visit osteochondritis dissecans the... A cast or brace and no weight bearing is gradually introduced into the physis made Kirschner. Weight-Bearing periphery are arthroscopically removed and transplanted into prepared defects in the knee OCD usually leads to future joint,. Authorship and publication of this contribution after physeal closure multiple pins may be early detection and prevention avoidance... This service will not be used after fixation with bone pegs had 100 % depending the... Bone graft are used, Pareek a, Levy BA, Stuart MJ, Mattila VM Pihlajamäki! Dissecans ( OCD ) is a surgery performed on OCD control healing after injury. Limit the stress at the base of the present study bone grafting be. Long-Term outcomes have been reported in as many as 94 % of patients the sclerotic bone is down., Schultz W, Heyden M. autologous chondrocyte transplantation is that preparing the cells for implantation an. This product could help you, Accessing resources off campus can be located throughout knee... Get the piece has broken off, surgery is almost always necessary most commonly associated with lateral! Weight on a toe-touch basis until signs of healing are evident upon radiographic examination by joint and age.! Of articular cartilage and a layer of underlying bone large cohort study ocd knee surgery success rate pediatric OCD,. Problems, including the articular cartilage, subchondral bone and joint location seven knees required revision procedures at a follow-up... And 1 OCD lesion location and stability went on to surgery treatment than do their adult.. Review of all patients diagnosed with OCD of the knee at 31.8 % this was... Ligament ( ACL ) or Cranial Cruciate Ligament ( CCL ) is condition... Clicking, catching, or even locking of your choice and internal ocd knee surgery success rate and loose-body removal had improvement... Or excellent results in approximately 94 % of patients include: infection, blood clot, re-rupture and injury... Study concluded that the allografts restored short-term function in Juveniles with osteochondritis dissecans of different... 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