Osteochondral injuries.

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Abstract

[Indexed for MEDLINE] 8. Orthop Traumatol Surg Res. 2018 Feb;104(1S):S97-S105. doi: 10.1016/j.otsr.2017.02.016. Epub 2017 Nov 29. Osteochondritis dissecans of the knee. Accadbled F(1), Vial J(2), Sales de Gauzy J(3). Author information: (1)Service de chirurgie orthopédique et traumatologique, hôpital des enfants, CHU de Toulouse, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France. Electronic address: faccadbled@gmail.com. (2)Service de radiologie, hôpital des enfants, CHU de Toulouse, France. (3)Service de chirurgie orthopédique et traumatologique, hôpital des enfants, CHU de Toulouse, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France. Osteochondritis dissecans (OCD) of the knee is an idiopathic, focal, subchondral-bone abnormality that can cause instability or detachment of a bone fragment and overlying articular cartilage, with subsequent progression to osteoarthritis. The diagnosis is usually made during adolescence. Mechanical factors play a major role in the pathophysiology of OCD. When the radiographic diagnosis is made early in a patient with open physes, healing can often be obtained simply by restricting sports activities. The degree of lesion instability can be assessed by magnetic resonance imaging. When the lesion remains unstable and the pain persists despite a period of rest, surgery is indicated. Arthroscopic exploration is always the first step. Drilling of the lesion produces excellent outcomes if the lesion is stable. Unstable lesions require fixation and, in some cases, bone grafting. Defects must be filled, depending on their surface area. Although many surgical techniques are available, the therapeutic indications are now standardized. Copyright © 2017 Elsevier Masson SAS. All rights reserved. DOI: 10.1016/j.otsr.2017.02.016