Search Our Scientific Publications & Authors

J Bone Joint Surg Am 2021 Jun;103(12):1132-1151

Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota.

➤: Osteochondritis dissecans occurs most frequently in the active pediatric and young adult populations, commonly affecting the knee, elbow, or ankle, and may lead to premature osteoarthritis.

➤: While generally considered an idiopathic phenomenon, various etiopathogenetic theories are being investigated, including local ischemia, aberrant endochondral ossification of the secondary subarticular physis, repetitive microtrauma, and genetic predisposition.

➤: Diagnosis is based on the history, physical examination, radiography, and advanced imaging, with elbow ultrasonography and novel magnetic resonance imaging protocols potentially enabling early detection and in-depth staging. Read More

Acta Orthop Traumatol Turc 2021 May;55(3):201-207

Department of Orthopaedics and Traumatology, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey.

Objective: The aim of this study was to present mid-term functional and radiological outcomes of patients with physeal closure who underwent arthroscopic or open internal fixation with headless cannulated compressive screws due to unstable Osteochondritis Dissecans (OCD) lesions of the knee.

Methods: With a diagnosis of unstable OCD of the knee, ten consecutive patients (seven male, three female) with physeal closure (mean age: 23 years; range: 17-40), underwent arthroscopic or open internal fixation with headless cannulated compressive screws. The patients were retrospectively reviewed based on functional and radiological data, with a mean follow-up of 42 months (range: 27-61). Read More

Arthroscopy 2021 Jun;37(6):1971-1972

Elbow arthroscopy has evolved to be a powerful tool for the treatment of a broad spectrum of pathologies over the past almost 40 years. The small joint with a complex arthroscopic anatomy demands special training and exceptional skills from the orthopaedic surgeon. On the basis of this fact and in light of the close proximity of the neurovascular structures, complication rates are somewhat higher compared with other large joints such as the knee and the shoulder. Read More

J Pediatr Orthop 2021 Jun 2. Epub 2021 Jun 2.

Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR.

Background: Osteochondritis dissecans (OCD) of the capitellum is a common cause of pain and dysfunction in adolescents that engage in repetitive elbow loading. For large, unstable lesions fresh osteochondral allograft transplantation (FOCAT) from the femoral condyle has been described as an effective treatment. Current practice involves significant guesswork in obtaining an appropriately sized graft, with anatomic variations resulting in poor graft fit. Read More

J Pediatr Orthop B 2021 May 28. Epub 2021 May 28.

Department of Orthopedics, Tokushima University Graduate School of Biomedical Sciences Department of Orthopaedic Surgery, Tokushima Red Cross Hospital Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences Department of Diagnostic Radiology, Tokushima University Graduate School of Health Sciences, Tokushima, Japan.

Objectives: To investigate the subchondral bone surface of the distal femoral epiphysis and monitor the morphologic changes on ultrasonography (US) in growing children.

Methods: A total of 160 football players aged 9-11 years underwent ultrasonographic examination of both knees. The regularity of the subchondral bone surface of the femoral condyles was classified as grade 0 (smooth), 1 (focal semilunar depression or indentation) or 2 (broad irregularity). Read More

World J Clin Cases 2021 May;9(15):3623-3630

Department of Orthopedics and Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China.

Background: Osteochondritis dissecans (OCD) is a rare disease of unclear cause characterized by subchondral bone damage and overlying cartilage defects. The current report presents the results of subchondral bone as a novel target for implantation of peripheral blood stem cells (PBSCs) in the treatment of OCD.

Case Summary: A 16-year-old patient diagnosed with OCD underwent subchondral bone implantation of PBSCs. Read More

J Child Orthop 2021 Apr;15(2):157-165

Miami Orthopedic and Sports Medicine Institute, Baptist Health South Florida, Miami, FL, USA.

Purpose: While predominant blood supply to the adult patella enters inferomedially, little is known about skeletally immature patellar perfusion. Improved knowledge of immature patella vascularity can further understanding of osteochondritis dissecans, dorsal defects of the patella and bipartite patella, and help ensure safe surgical approaches. We hypothesized that the immature patella would exhibit more uniform blood flow. Read More

Orthopedics 2021 May-Jun;44(3):e378-e384. Epub 2021 May 1.

The purpose of this study was to evaluate the effect of race, insurance status, and socioeconomic status on successful or unsuccessful healing of osteochondritis dissecans (OCD) lesions in the pediatric knee. The authors retrospectively reviewed patients younger than 18 years who were treated for a knee OCD lesion between 2006 and 2017. Patients were required to have at least 6 months of clinical and radiographic follow-up to be included, unless complete healing was achieved sooner. Read More

Arthrosc Sports Med Rehabil 2021 Apr 16;3(2):e593-e603. Epub 2021 Mar 16.

Department of Orthopedics, Mayo Clinic Sports Medicine Center, Rochester, Minnesota, U.S.A.

Purpose: To analyze the available literature pertaining to the indications, outcomes, and complications of both microfracture (MFX) and simple debridement for capitellar osteochondritis dissecans (OCD).

Methods: A comprehensive literature review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) criteria. Studies were included if they evaluated OCD of the capitellum that underwent either arthroscopic debridement (AD) or MFX. Read More

Orthop J Sports Med 2021 Apr 15;9(4):2325967121997120. Epub 2021 Apr 15.

Division of Sports Medicine, Department of Orthopaedic Surgery, Duke Sport Science Institute, Duke University, Durham, North Carolina, USA.

Background: Osteochondral lesions of the tibial plafond (OLTPs) remain less common than osteochondral lesions of the talus (OLTs), but recognition of the condition has increased.

Purpose: To systematically evaluate the literature on lesion locations and treatment outcomes of OLTPs, whether in isolation or in combination with OLTs.

Study Design: Systematic review; Level of evidence, 4. Read More

Foot (Edinb) 2021 Jun 20;47:101805. Epub 2021 Apr 20.

East Kent Hospitals NHS University Foundation Trust, Ashford, United Kingdom.

Background: There has been no consensus regarding the treatment of osteochondral lesions of the talus, there has been many attempts to formulate a treatment pathway, with multiple proposed modalities and adjuncts used.

Objectives: The aim of this paper was to investigate the evidence published in the recent history, identify the relevant papers, review and summarize the findings, to help clarify the available operative treatment options and their respective efficacies based on the level of evidence provided.

Study Design & Methods: A literature search through electronic databases MEDLINE and EMBASE was done, these databases were screened for publications and papers form June 2004 to June 2019. Read More

Res Sports Med 2020 Dec 1:1-10. Epub 2020 Dec 1.

Sports Injuries Research Group, Edge Hill University, Ormskirk, UK.

This case summarizes the rehabilitation and return to play management of a 17-year-old elite male soccer player who required surgical stabilization of an Osteochondritis Dissecans (OCD) lesion of the trochlea groove. Trochlea groove lesions represent <1% of OCD cases, resulting in limited evidence to inform practice. The case was initially identified as antalgic running gait, and at this point the player revealed progressively worsening knee pain (over preceding 2 months) which presented as patellofemoral pain with a small knee effusion and quadriceps atrophy present on assessment. Read More

J Hand Surg Am 2021 Apr 27. Epub 2021 Apr 27.

Department of Orthopedic Surgery, Washington University, St. Louis, MO. Electronic address:

Purpose: Outcome measures that lack sensitivity for the detection of clinical changes early after surgery for capitellar osteochondritis dissecans (OCD) make it difficult to determine the optimal treatment for these defects. We sought to evaluate the early responsiveness of patient-reported outcomes measurement information system (PROMIS) scores in a cohort of patients operatively treated for capitellar OCD.

Methods: Four PROMIS questionnaires (mobility, upper extremity [UE], pain interference, and peer relations) were electronically administered to patients treated for capitellar OCD at a single tertiary academic medical center between January 1, 2015, and July 1, 2018. Read More

Knee 2021 Apr 27;30:157-162. Epub 2021 Apr 27.

Knee Unit, Department of Orthopedic Surgery and Traumatology, Parc Taulí University Hospital, Institut d'Investigació i Innovació Parc Taulí CSPT, Autonomous University of Barcelona, Sabadell, Spain.

Purpose: Osteochondritis dissecans (OCD) of the patella is a very rare affliction. The aim of this case series is to evaluate the effectiveness of the Nanofractured Autologous Matrix-Induced Chondrogenesis (NAMIC) technique for the treatment of OCD in young adults.

Methods: Five consecutive patients with patellar osteochondral lesions treated with NAMIC were prospectively studied. Read More

J Hand Surg Am 2021 Apr 23. Epub 2021 Apr 23.

Department of Orthopedic Surgery, Shriners Hospitals for Children, Philadelphia, PA.

Purpose: To assess the outcomes of osteochondral autograft transplantations in the treatment of osteochondritis dissecans of the capitellum in the pediatric population.

Methods: Between 2011 and 2016, 15 patients who had undergone osteochondral autograft transplantation at a mean age of 13.7 years at surgery were identified. Read More

Cartilage 2021 Apr 24:19476035211003325. Epub 2021 Apr 24.

General University Hospital of Larissa, Larisa, Greece.

Objective: This study aimed to assess the clinical and radiographic outcomes of juvenile patients who suffered from stage II or III osteochondritis dissecans (OCD) of the knee and underwent arthroscopic retrograde drilling and internal fixation with bioabsorbable pins.

Design: Medical and radiological records from patients aged 11 to 16 years, who underwent arthroscopic treatment for OCD lesions of the knee in 2 tertiary hospitals, were retrospectively reviewed. The procedure was indicated by persistent pain and by magnetic resonance imaging (MRI). Read More

Arthroscopy 2021 05;37(5):1597-1598

La Jolla, California.

Fresh osteochondral allograft transplantation has been my preferred procedure for chondral and osteochondral lesions for many decades. This is particularly true for patients younger than 18 years of age, where diagnoses such as osteochondritis dissecans, osteochondral fractures, and osteonecrosis predominate, rendering the situation as much a "bone problem" as a "cartilage problem." In the universe of cartilage-repair techniques, osteochondral allografts are particularly useful when bone defects must be managed. Read More

BMJ Case Rep 2021 Apr 23;14(4). Epub 2021 Apr 23.

Trauma and Orthopaedics, Royal Free London NHS Trust, London, UK.

Osteochondral defect or osteochondritis dissecans (OCD) of the knee usually affects young, active populations. It is a challenging diagnosis as patients typically present with poorly localised activity-related pain, which is non-specific and covers many differentials. We present an active 11-year-old girl with bilateral osteochondral defects of the patellae: a rare clinical disorder which was affecting her sporting activities. Read More

Orthop J Sports Med 2021 Apr 7;9(4):23259671211007741. Epub 2021 Apr 7.

Department of Orthopaedic Surgery, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan.

Background: Osteochondritis dissecans (OCD) of the humeral capitellum occurs in adolescent overhead athletes, and medial epicondyle (ME) lesions are also common in this population.

Purpose: To evaluate the association between elbow OCD and ME lesions in adolescent baseball players.

Study Design: Cross-sectional study; Level of evidence, 3. Read More

Am J Sports Med 2021 Apr 22:3635465211000763. Epub 2021 Apr 22.

Brighton and Sussex University Hospital, Brighton, UK.

Background: The optimum management of osteochondritis dissecans (OCD) of the capitellum is a widely debated subject.

Purpose: To better understand the efficacy of different surgical modalities and nonoperative treatment of OCD as assessed by radiological and clinical outcomes and return to sports.

Study Design: Systematic review; Level of evidence, 4. Read More

Curr Rev Musculoskelet Med 2021 Jun 5;14(3):239-245. Epub 2021 Apr 5.

Department of Physical Medicine and Rehabilitation, Stanford University, 500 Jefferson Avenue #823, Redwood City, CA, 94063, USA.

Purpose Of Review: This review article seeks to highlight common youth athlete knee conditions due to overuse or trauma and elucidate differences from the adult populations.

Recent Findings: Overuse conditions presented include apophysitis, osteochondritis dissecans plica syndrome, and discoid meniscus. Traumatic conditions presented include patellar instability, patellar sleeve fracture, and patellofemoral osteochondral fractures. Read More

Orthop J Sports Med 2021 Mar 18;9(3):2325967121989108. Epub 2021 Mar 18.

Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University, Tokushima, Japan.

Background: Reducing the number of pitches thrown is regarded as the most effective way to prevent throwing injuries in youth baseball pitchers. However, few studies have compared the effectiveness of limiting the pitch count versus the limiting the number of innings pitched in terms of elbow injuries.

Hypothesis: We hypothesized that, compared with inning limits, pitch count limits would lead to greater decreases in elbow pain, range of motion deficits, positive moving valgus stress test results, and the risk of capitellar osteochondritis dissecans (OCD). Read More

J Hand Surg Am 2021 Jun 29;46(6):454-461. Epub 2021 Mar 29.

Department of Orthopedic Surgery, Washington University School of Medicine, St Louis, MO. Electronic address:

Purpose: Magnetic resonance imaging (MRI) is a helpful tool in the evaluation of osteochondritis dissecans (OCD) of the humeral capitellum. The relationship between MRI appearance and clinically relevant intraoperative findings is incompletely understood. The goal of this study was to evaluate capitellar OCD lesions via preoperative MRI and to determine its accuracy in predicting lesion characteristics including lesion size and capitellar lateral wall integrity. Read More

J Pediatr Orthop 2021 Jul;41(6):e422-e426

Department of Orthopaedic Surgery & Sports Medicine, Boston Children's Hospital.

Background: Current advanced imaging classification systems for osteochondritis dissecans (OCD) of the knee grade severity of disease by identifying certain lesion characteristics. The most widely used are the Hefti and Nelson systems. A novel classification presents a simpler 3-group approach to diagnose knee OCD by magnetic resonance imaging (MRI), compared with the Hefti (5-group) and Nelson (4-group) classifications. Read More

Am J Sports Med 2021 Mar 29:3635465211000776. Epub 2021 Mar 29.

OrthoCarolina, Charlotte, North Carolina, USA.

Background: Gymnastics is a unique sport that places significant loads across the growing elbow, resulting in unique overuse injuries, some of which are poorly described in the current literature.

Purpose: To provide a comprehensive review of the unique overuse elbow injuries seen in youth gymnasts and to provide an up-to-date synthesis of the available literature and clinical expertise guiding treatment decisions in this population.

Study Design: Narrative review. Read More

Injury 2021 Mar 18. Epub 2021 Mar 18.

Department of Pediatric Orthopaedics, Children's Hospital Hamburg-Altona, Hamburg, Germany; Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address:

Aims: Biodegradable magnesium-based alloy implants represent a promising option in orthopedic surgery, as the clinical outcomes have been reported to be comparable to those of titanium implants and no surgical interventions are required for removal. To date, little is known about the results of the use of these implants in children and adolescents. Therefore, the aim of the present study was to analyze the safety and performance of these implants in children and adolescents. Read More

Arthrosc Tech 2021 Mar 10;10(3):e705-e709. Epub 2021 Feb 10.

Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan.

Osteochondritis dissecans (OCD) of the knee is a subchondral bone abnormality that results in the separation of the articular cartilage and bone with subsequent progression to osteoarthritis. Unstable OCD lesions should undergo fixation to preserve the natural contour of the articular surface. Although several fixation procedures have been reported, the appropriate procedure remains unknown. Read More

Vet Comp Orthop Traumatol 2021 03 16;34(2):v-vi. Epub 2021 Mar 16.

Sydney School of Veterinary Science, University of Sydney, Sydney, New South Wales, Australia.

J Orthop Surg Res 2021 Mar 15;16(1):187. Epub 2021 Mar 15.

Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.

Background: The aim of this study is to analyse the re-operation rate after surgical treatment of osteochondral lesions of the talus (OCLTs) in children and adolescents.

Methods: Between 2009 and 2019, 27 consecutive patients with a solitary OCLT (10 male, 17 female; mean age 16.9 ± 2. Read More