Bilateral osteochondritis dissecans of the knee in pediatric and adolescent patients presenting with unilateral symptoms: an epidemiological and radiographic analysis

Review written by Sam Blanchard info

Key Points

  1. One in seven patients with unilateral knee pain went on to have bilateral pathology.
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BACKGROUND & OBJECTIVE

Osteochondritis dissecans (OCD) is an idiopathic condition that primarily affects the subchondral bone with secondary consequences on the articular surface of the joint. It most commonly affects the knee but can also occur in the talus and the elbow. Much more research is needed to understand the pathology and etiology but it is believed to be multifactorial, with debate around repetitive microtrauma and genetic predisposition.

It is becoming increasingly common in youth sports, suggesting that it may have links to overuse. Inadequate healing leads to risk of necrosis and fragment separation, with younger age being an independent variable for healing, highlighting a need for early identification. It is currently not commonplace for asymptomatic knees to be imaged following diagnosis of OCD.

The objective of this study was to identify how common and what specific traits characterize bilateral OCD of the knee in patients who initially present with symptoms affecting only one side, and to contrast this group with patients having unilateral knee conditions.

Osteochondritis dissecans is an idiopathic condition that primarily affects the subchondral bone with secondary consequences on the articular surface of the joint.
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This study highlights the risk that a seemingly unaffected, asymptomatic limb may in fact have a similar pathology and also require a period of offloading and protection.

METHODS

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