Osteochondritis dissecans ocd is a condition that develops in joints, most often in children and adolescents. Osteochondritis dissecans of the talus ankle a large percentage of lesions of the talus appear to be directly related to trauma. Osteochondritis dissecans radiology reference article. The arthroscopic management of osteochondritis dissecans of the adolescent elbow. Symptoms of osteochondritis dissecans include pain, swelling. Due to persisting symptoms, an arthrotomy was performed on may 7, 1952, with excision of the osteocartilaginous fragment from the right talus and removal of a biopsy specimen from the joint capsule. Osteochondritis dissecans, transchondral and osteochondral fractures are collectively known under the generic term osteochondral lesions of the talus. Osteochondritis dissecans ocd is an aseptic bone necrosis and represents pathology of high clinical relevance, which is frequently located on the talus. Osteochondritis dissecans occurs most often in children and adolescents. Osteochondritis dissecans ocd is the end result of the aseptic separation of an osteochondral fragment with the gradual fragmentation of the articular surface. Pdf surgical treatment of osteochondritis dissecans of the. Osteochondritis dissecans is a bone and cartilage condition that most often occurs in the knee.
Article information, pdf download for treatment of osteochondritis. Osteochondral lesions include osteochondritis dissecans, osteochondral fractures, and osteochondral abnormali. Report of 55 cases with special reference to etiology and treatment. Osteochondritis dissecans of the talus in children request pdf. This softening is caused by an interruption in the blood flow to that portion of the bone. Osteochondritis dissecans ocd fixation knee osteochondritis is a condition in which the blood supply to an area of bone is disrupted. Physiotherapy in kleinburg for osteochondritis dissecans. Aug 01, 2014 osteochondritis dissecans ocd is an acquired idiopathic lesion of subchondral bone that can produce delamination and sequestration with or without articular cartilage involvement and instability. A patients guide to osteochondritis dissecans of the talus introduction.
Osteochondritis dissecans ocd is a common, yet poorly understood cause of knee pain in the pediatric and juvenile population as well as an adult form that can occur in the developed skeleton. Osteochondritis dissecans osteochronditis dissecans aka ocd is a condition in which the bone that supports the cartilage inside a joint undergoes softening. In later stages of the disorder there will be swelling of the affected joint which catches and locks during. Ocd of the talus usually occurs in patients aged between 10 and 40 years, and it. Osteochondritis dissecans ocd of the knee is an acquired, reversible, idiopathic condition of the subchondral bone. Olts have been known historically by varied nomenclature, including osteochondritis dissecans, talar dome fracture, transchondral fracture, and flake fracture. A variety of treatments, both conservative and surgical, have been used for these osteochondral lesions. In ocd, a portion of the bone or cartilage separates from the surface of the joint and creates pain, swelling and sometimes a locking sensation. The ankle is the third most frequently affected site, after the knee and elbow, and it accounts for 4% of all ocd cases 1, 2. The condition happens most often in the knees, but your child can also have it in the elbows, ankles, and other joints.
Osteochondritis dissecans ocd of the talus is a disease affecting the subchondral bone and secondarily the articular cartilage. The talus is particularly at risk for injuries when it is twisted up and in or down and out. Ice is applied for 20minute periods 34 times per day. Transchondral fractures osteochondritis dissecans of the. Pdf surgical treatment of osteochondritis dissecans of. Pdf osteochondritis dissecans of the talus treated by. Osteochondritis dissecans ogd of the talus is a common problem that frequently requires surgical in tervention and treatment. Osteochondritis dissecans ocd or od is a joint disorder in which cracks form in the articular cartilage and the underlying subchondral bone.
Osteochondritis dissecans is a condition that occurs in the joints the place where the end of one bone meets the end of another bone when a lack of blood to the joint causes the bone inside to soften. Osteochondritis dissecans ocd is an acquired idiopathic lesion of subchondral bone that can produce delamination and sequestration with or without articular cartilage involvement and instability. The lesion is encountered on either the medial or lateral surface of the talar. Most of the time, it gets better when you rest the joint for a while. Osteochondrosis dissecans des talus im uberblick springerlink. Treatment of juvenile osteochondritis dissecans of the talus.
Jun 10, 2016 osteochondritis dissecans ocd is a pathological process affecting the subchondral bone most often in the knee joint of children and adolescents with open growth plates juvenile ocd and young adults with closed growth plates adult ocd. This results in a small piece of the bone dying and separating from the larger bone. Pitfalls, injuries, and osteochondritis dissecans osteochondral lesions most commonly occur about the knee but may affect any ar ticular surface of the pediatric appendicular skeleton. A prospective, randomized clinical study of osteochondral autologous transplantation versus microfracture for the treatment of osteochondritis dissecans in the knee joint in children. The literature on the best treatment of osteochondritis dissecans of the talus ocdt in children is scarce because of rarity of the condition. Management of osteochondral lesions of the talar dome. Osteochondritis dissecans of the talus radiology case.
Copyright 0 1989 by the american orthopaedic foot and ankle society. Outcomes are favorable after arthroscopic treatment of osteochondritis dissecans of the talus. Treatment strategies in osteochondral defects of the talar dome. This is an enhanced pdf from the journal of bone and joint surgery j bone joint surg am. However, affected people may experience pain, weakness andor decreased range of.
Cartilage is a tough but flexible tissue that covers the ends of the bones at joints and is also part of the developing skeleton. In 1888 konig was the first author to use the term osteochondritis dissecans to describe loose bodies found in the knee joint. Osteochondritis dissecans with decalcification round the fracture area see fig. Methodology of these studies was system atically analyzed by the means of the coleman method introduction ology score. Care of the young athlete, 2nd ed, anderson sj, harris ss, gregory ajm eds, american academy of pediatrics, elk grove village 2010. It is often associated with intraarticular loose bodies. Juvenile osteochondritis dissecans od of the talus is a rare disease, affecting subchondral bone and, secondarily, articular cartilage in a skeletal immature population, usually sited in the. Osteochondral lesions of the talus otl are among those injuries that we should not fail to. Berndt and michael harty transchondral fractures osteochondritis dissecans of the talus this information is current as of october 30, 2007 errata. In a large metaanalysis, 96% of lesions on the lateral aspect and 62% of lesions on the medial aspect of the talus were related to a. Lateral lesions have a higher incidence of a specific traumatic event. An evidencebased treatment algorithm is still lacking. Pmc created 101817 phase 3 weeks twelve to discharge evaluate strength and balance address any deficits that may limit return to work or sport expectations hep compliance assess.
The cause is currently unknown but it may lead to damage to overlying cartilage, loose bodies, and joint damage. Gudas r, simonaityte r, cekanauskas e, tamosiunas r. Osteochondral lesions of the talus olt bring the challenges both of articular cartilage healing and a constrained area of access in the ankle joint. Welcome to rocky mountain therapy services patient resource about osteochondritis dissecans of the talus. Outcome and success rate was evaluated in dependence of surgical treatment applied and in depen osteochondritis dissecans ocd represents a pathology of dence. Usually the person affected can remember having injured the joint. Physical examination typically reveals an effusion, tenderness, and a crackling sound with joint movement. Rehabilitation guidelines for osteochondritis dissecans. Trauma is now considered to be a caus ative factor.
Osteochondritis dissecans is an acquired, potentially reversible idiopathic lesion of subchondral bone resulting in delamination and sequestration with or without articular cartilage involvement and instability. Progression of the defect can result in varying degrees of fragmentation from the articular surface and surrounding cartilage. Osteochondritis dissecans of the talus transchondral. Osteochondritis dissecans ocd of the talus is a subchondral bone pathology that presents as an osteochondral lesion of the talar dome with. This condition is also known as osteochondritis dissecans ocd of the talus or a talar osteochondral lesion ocl. Treatment of osteochondritis dissecans of the talus. In a large metaanalysis, 96% of lesions on the lateral aspect and 62% of lesions on the medial aspect of the talus were related to a traumatic event, typically a lateralinversion ankle sprain. Osteochondritis dissecans of the talus sage journals. It occurs when a small segment of bone begins to crack and separate from its surrounding region due to a lack of blood supply. Osteochondral lesions of the talus otl are among those injuries that we should not fail to recognize, especially following any type of hindfoot injury. Osteochondritis dissecans ocd of the elbow is a condition that occurs in children and adolescents who participate in sports that place a large amount of stress on the elbow joint. The forces needed to cause ocd are produced primarily in athletes participating in baseball and gymnastics. It was not until 1922 that the first report on osteochondritis dissecans in the ankle.
Osteochondral lesions of the talus are a common occurrence especially in sports, occurring 6. Osteochondritis dissecans symptoms and causes mayo clinic. The etiology of the aseptic bone necrosis still remains unclear. This bone and cartilage can then break loose, causing pain and possibly hindering joint motion. Mosaicplasty for the treatment of osteochondritis dissecans of the talus. Management of osteochondritis dissecans ocd uptodate. Osteochondritis dissecans of the talus sometimes sever ankle sprains can result in injury to the bones of the ankle, particularly the talus, in addition to the usual injuries to the ligaments. Osteochondritis dissecans ocd of the talus is a subchondral bone pathology that presents as an osteochondral lesion of the talar dome with consequent articular cartilage abnormalities. Familial osteochondritis dissecans genetics home reference. Feb 08, 2015 osteochondritis dissecans is a joint condition that occurs when a piece of cartilage and the thin layer of bone beneath it, separates from the end of the bone. Osteochondritis dissecans ocd is a bone and cartilage injury that affects the knee, ankle and elbow. Osteochondritis dissecans of the talus is classically characterized by an abnormality of the articular cartilage of the talar dome. Osteochondritis dissecans genetic and rare diseases. We report a rare case of a lesion of the subtalar facet in a 10.
Familial osteochondritis dissecans is a condition that affects the joints and is associated with abnormal cartilage. Transchondral fractures osteochondritis dissecans of the talus. In addition, patients with this condition typically become asymptomatic long before radiographic healing is complete that might give a. It can cause symptoms either after an injury to a joint or after several months of activity, especially highimpact activity such as jumping and running, that affects the joint.
Osteochondritis dissecans is a similar disorder in which a piece of joint cartilage and of underlying bone breaks off and lodges in the joint cavity. Welcome to advantage physiotherapys patient resource about osteochondritis dissecans of the talus. Osteochondritis dissecans is a joint condition that occurs when a piece of cartilage and the thin layer of bone beneath it, separates from the end of the bone. Benign noninflammatory condition affecting young adults, with necrosis of subchondral bone and adjacent articular cartilage causing separation from adjacent structures.
The full text of this article is available in pdf format. It occurs when a small segment of bone begins to separate from its surrounding region due to a lack of blood supply. Eleven patients with osteochondritis dissecans lesions, 10 mm or grea. Ankle arthroscopy osteochondritis dissecans protocol phase 1 weeks two to six phase 2 weeks six to twelve initial evaluation evaluate arom hipkneeankle pain level edema nwb 46 weeks per md sutures removed utilize arom hep in favor of formal therapy for initial 4weeks per md painedema. Open mosaicplasty in osteochondral lesions of the talus. Osteochondritis dissecans is a painful joint problem. Lesions of chondral and osteochondral tissues of the ankle are commonly. As a result, it is possible for portions of cartilage to become lodged within the joint, leading to limitation in motion. Osteochondritis dissecans knee pediatric orthopaedic. Management of osteochondral lesions of the joint has been difficult, because articular cartilage has a poor healing capacity as a result of its lack of vessels, nerve supply, and its isolation of systemic regulation.
It has no known cause, but repetitive stress on the joint, low vitamin d and a genetic predisposition are often linked to this condition. Most cases of ocd usually follow a twisting injury to the ankle and are actually fractures of the joint surface. If the piece of cartilage and bone remain close to where they detached, they may not cause any symptoms. Various treatment strategies including nonsurgical and surgical approaches have been described. Osteochondritis dissecans and similar lesions of the talus. Diagnosis and treatment of osteochondral lesions of the ankle. Stage 2 osteochondritis dissecans with double line sign on t2weighted images. An osteochondral lesion of the talus olt is an area of abnormal, damaged cartilage and bone on the top of the talus bone the lower bone of the ankle joint.
Damage to the talus may not be obvious at first despite a. The pdf of the article you requested follows this cover page. Its most common in children and teens who are active in sports. Ocd usually causes pain and swelling of the affected joint which catches and locks during movement. As a result, the area of bone and its overlying cartilage can separate from the rest of the bone. This piece of bone and cartilage can become loose and even break off into the joint. Osteochondritis dissecans of the talus transchondral fractures of the talus. Osteochondritis dissecans causes irregularity and fragility of affected cartilage. Osteochondritis dissecans symptoms, diagnosis and treatment. When osteochondritis dissecans affects the ankle it typically occurs on the inner or medial portion of the ankle talus.
Osteochondritis dissecans of the talus is a subset of osteochondral lesions of the talus that also includes osteochondral fractures, avascular necrosis, and degenerative arthritis. Osteochondritis dissecans of the talus in children. Osteochondritis dissecans ocd is a problem that causes pain and stiffness of the ankle joint. Osteochondritis dissecans ocd or od is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone may happen. Osteochondritis dissecans ocd of the talus is rare in children. Osteochondritis dissecans etiology bmj best practice. Mosaicplasty for the treatment of articular defects of the knee. Osteochondritis dissecans is a joint condition whereby a variable amount of bone and its adjacent cartilage loses its blood supply. This bone piece, along with cartilage that covers and. Surgical treatment of osteochondritis dissecans of the talus.
The condition occurs most commonly in the knee, but also occurs in elbows, ankles and other joints. Osteochondral lesions of the talus can be associated with injury to the ankle. Osteochondritis dissecans ocd is an idiopathic disorder of subchondral bone and articular cartilage in which a segment of the subchondral bone separates from the surrounding bone. Pdf osteochondritis dissecans ocd is an aseptic bone necrosis and represents pathology of high clinical relevance, which is frequently located on. Jul 11, 2012 osteochondritis dissecans can often be a progressive pathologic process. Ankle arthroscopy osteochondritis dissecans protocol. Pdf surgical treatment of osteochondritis dissecans of the talus. In addition, patients with this condition typically become asymptomatic long before radiographic healing is complete that might give a false perception of clinical success. Rehabilitation guidelines for osteochondritis dissecans ocd.
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