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Topic:

Osteochondritis Dissecans

Issue:

Knee

Category:

​

Title:

Patella and Trochlea Osteochondritis Dissecans: Demographics and Treatment Paradigms

Author:

Kiani, Sara N. MD, MPH; Yellin, Joseph L. MD; Huffman, William H. BS; Guzek, Ryan H. MD; Shea, Kevin G. MD; Nguyen, Jie C. MD, MS; Ganley, Theodore J. MD

Journal:

Journal of Pediatric Orthopaedics

Date:

February 2024

Reference:

44(2): p e138-e143, DOI: 10.1097/BPO.0000000000002588

Level Of Evidence:

III

# of Patients:

68 patients (75 knees)

Study Type:

Retrospective cohort study

Location:

Single institution (from 2008 to 2021)

Summary:

This study investigates osteochondritis dissecans (OCD) lesions in the patella and trochlear groove, focusing on patient demographics, treatment outcomes, and the effectiveness of both operative and nonoperative approaches.

Methods:

A retrospective cohort study was conducted on patients diagnosed with patellar and/or trochlear OCD lesions. Minimum follow-up was 12 months. Outcomes measured included return to sport (RTS), pain resolution, radiographic healing, and treatment success (defined as full RTS, complete pain resolution, and full healing).

Exclusions:

Patients without available surgical records or those who had knee surgery for a different injury during the study period or in the 12 months postoperatively.

Results:

Demographics: 69% male, median age at diagnosis 14 years. Return to Sport: 62% of knees (44/75) returned to full sport participation. Pain Resolution: 54% of knees (39/75) had full pain resolution. Radiographic Healing: 63% of knees (46 patients with follow-up imaging) showed complete healing of the lesion. Comparison of Treatments: There was no significant difference in RTS, pain resolution, radiographic healing, or overall success between operative and nonoperative treatment approaches.

Conclusions:

The study provides important epidemiologic data on patellar and trochlear OCD. While more than half of the patients returned to sports and had pain resolution, a considerable number continued to experience symptoms. The study calls for further research to refine treatment algorithms for these OCD subtypes.

Relevance:

Limitations:

Perspective:

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