OCD
Arthroscopic Bone Graft and Screw Fixation
Case 1: Type 3 Large Unstable MFC OCD
MRI
MRI demonstrates large OCD with fluid completely separating bone on all views
Plan
Probably unstable
Management
NHx
European Orthopaedic Paediatric Study JPO 1999
- 452 patients
- juvenile and adult
Findings
- stable lesion with cartilage intact and no dissection had good prognosis
- if signs dissection, surgical management better than non surgical
- sclerosis on x-ray poor prognostic sign
- lesions > 2cm poor prognosis
- 20% OCD in juveniles abnormal x-ray findings at 3 years (not benign process)
Background
Definition
Osteochondritis Dissecans
- separation of avascular fragment of bone & cartilage
Epidemiology
M : F = 2:1
Mean age 18 years
- can present as young as 9
4:1000
Ankle osteochondral lesions
Definition
Fracture talus through articular cartilage into subchondral bone
- 2° force transmitted from distal tibia
Osteochondritis dissecans v osteochondral fracture
Epidemiology
6% ankle sprains
Average age = 25
M > F
Location