Juvenile osteochondritis dissecans (JOCD) of the knee: current concepts review

[摘要] Osteochondritis dissecans (OCD) is an acquired condition of the joint that affects the articular surface and the subchondral bone. The term osteochondritis dissecans was first coined by Konig in the late 1880s; he described it as an inflammation of the bone cartilage interface.1 The most commonly affected joint is the knee, followed by the ankle, elbow, shoulder and hip. The juvenile form of the disease (JOCD) presents in those aged five to 16 years with open growth plates.2 The causes of OCD are unknown; however, repetitive trauma, inflammation, accessory centres of ossification, ischaemia and genetic factors has been proposed.3–10 The clinical presentation of JOCD is highly variable, with some children being completely asymptomatic. Pain can be poorly localized in nature; there may also be associated joint swelling and mechanical symptoms. The knee is the most common lesion site for JOCD and the most prevalent location is within the lateral aspect of the medial femoral condyle. The goals of treatment are to promote healing of the subchondral bone and prevent chondral collapse, subsequent fracture, osteochondral defect formation and early joint degeneration. Treatment modality depends on the skeletal maturity of the patient, as well as the size, stability and location of the lesion.

[学科分类] 神经科学

[关键词] juvenile osteochondritis dissecans;knee joint;paediatric