2). Osteochondral fracture of the patella is a common concomitant injury of the knee, especially in lateral patellar instability, and the importance of early stable fixation with minimal complication and early mobilization should be emphasized. Please note that OCD is a commonly used abbreviation for both osteochondral defect and osteochondritis dissecans, two closely related conditions. The only difference is that with an osteochondral fracture, there may also be a bone fracture involved. 1A, B, C) in association with an anteromedial detachment of a bony fragment.A three-dimensional CT scan was realized to define the exact position and dimension of the fragment that was rotated at 90° in the sagittal plane with the articular surface oriented anteriorly (Fig. https://radiopaedia.org/articles/osteochondritis-dissecans-of-the-knee Furthermore, on standard knee X-rays these injuries may not be seen and thus not properly be treated. Knee osteochondral fractures in skeletally immature patients: French multicenter study Better knowledge of this fracture and attentive reading of the radiographic images of a knee with hemarthrosis should result in more frequent diagnosis of this condition and adapted treatment. Osteochondral fractures may occur with patellar dislocations (see Fig. 9 In the early phase, when they are best treated, osteochondral defects can only be seen on MRI (Figure 8). Prognosis of these lesions depends on stability, location, and size of the lesion. This study determined that chondral injuries were more frequently detected compared with meniscal and ACL injuries, and patterns varied depending on stage of physeal closure. Examination and imaging identified a loose osteochondral fracture. Osteochondral lesions are relatively common in children and adolescents, and the incidence is increasing. ... Isolated chondral fractures of the knee. The use of fresh osteochondral allograft transplantation for tibial plateau lesions has been well documented. An Osteochondral fracture is a tear of the cartilage which covers the end of a bone, within a joint. One part was fixed with polydioxanone suture through drill holes and the other was removed. Surgery was indicated to remove and potentially reattach the loose body. Osteochondral Fractures are also sometimes known as articular cartilage injuries. Prognosis of these lesions depends on stability, location, and size of the lesion.Imaging has an essential role in the diagnosis, staging, and management of osteochondral lesions. Osteochondral fracture In terms of medial patellar OCF fragment, it was classified based on the location of fracture site, patellar medial margin, inferomedial facet, and inferomedial facet involving central ridge [ 25 ]. 6-11). Osteochondral lesions are relatively common in children and adolescents, and the incidence is increasing. [1] Osteochondral fractures … Patellar dislocation is a common sports injury of the knee in adolescents ().During the dislocation and reduction process, the medial facet of the patella shears with the lateral femoral condyle, which often results in patellar or lateral femoral condylar osteochondral fractures (OCFs) (2,3).The incidence of OCF following a patellar dislocation varies from 5% to 54% (4,5). Current theory for aetiology favours repetitive microtrauma with microtrabecular fractures of subchondral bone, subsequent ischaemia and altered local growth. Less common are impression fractures of the retropatellar joint or the lateral trochlea. AJR, 1998; 170:1207-1213 Without refixation of the osteochondral fragment, human cartilage can only repair these defects imperfectly. Osteochondral injuries, if not treated adequately, often lead to severe osteoarthritis of the affected joint. The most common sites are the posteromedial (53%) ( Fig. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Osteochondral Injury, Knee The goal of treatment is a pain-free range of motion of the knee that provides enduring function and enables a young patient to participate in a wide range of activities. Osteochondral fracture occurred at the patella in 35 patients (76%), the lateral femoral condyle in 11 patients (24%), and at both locations in 3 patients (6.5%). We describe the clinical and radiographic features of 11 athletes found to have femoral head lesions similar in MR imaging appearance to osteochondral lesions in other locations, such as the knee … There were two parts in the partial osteochondral avulsion fracture of the PCL posteromedial (PM) bundle. Fractures of the fibular neck and head may be associated with damage to the common peroneal nerve and collateral ligament complex and may be part of a pronation lateral rotation ankle injury. Depending on the severity of the fracture, there are a number of treatment options ranging from fairly conservative treatments to surgery. Many of these lesions are first diagnosed by plain film. The loose body was localized arthroscopically, and an … Patella (40%) 1. X-ray evaluations presented a posteromedial tibial plateau fracture with a disruption of a bone portion (Fig. Introduction. They are used primarily to confirm/exclude a fracture, or to assess the level of osteoarthritis in the knee joints (= gonarthrosis). Unlike osteochondral fractures, chondral fractures exhibit no specific abnormalities on routine radiography, necessitating arthroscopy or arthrography for diagnosis. Keywords: Knee, Cartilage, Synovitis, Pigmented villonodular Pigmented villonodular synovitis (PVNS) is a rare, benign, but potentially recurrent condition with an estimated incidence of 1.8 per million. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. Most classification systems are based on lesion descriptions by Berndt and Harty ( 2 ): These fractures are most commonly seen in the knee and ankle joints, as these joints take a lot of strain and bear a lot of weight, which can make them vulnerable to damage. Osteochondraldefect is a broad term that describes the morphological change of a localized gap in the articular cartilage and subchondral bone 5. Sometimes the t… Screws and Kirschner wires both absorbable and nonabsorbable have been the common mode of fixation of these fractures. An osteochondral fracture is caused by tearing of the articular cartilage. The second most common cause of hemarthrosis to the knee, after ACL injury, is patellar dislocation with an incidence of osteochondral fracture in approximately 70% of patients [23-25] (Fig. A 16-year-old male presented after a twisting injury of the knee. Introduction. By presenting our cases we show clinical symptoms, diagnostic pathways and the therapeutic approach for osteochondral fractures of the distal femur. Frequent abnormalities found on MR imaging include labral tear or injury, stress fracture, and avascular necrosis . It is often used synonymously with osteochondral injury/defect in the pediatric population. 1 ) and anterolateral (46%) talar dome ( 1 ). 1 Osteochondral fractures, sometimes called ‘flakes’, occur as a completely detached or partially attached fragment. Top Magn Reson Imaging 1998; 9:348-359. In the late phase, which is more common with presentations in young adults, they can dislodge from the bone, leaving a defect in the articular surface … … The incidence of osteochondral fractures with ACL injuries may be as high as 80% [20, 21]. The articular cartilage is responsible for covering the endpoint of bone in a joint and is susceptible for tearing in case of a direct or forceful impact or a twisting movement. 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. The biological effect of continuous passive motion on the healing of … 3). 6-12) or anterior cruciate ligament (ACL) repairs. There is often an associated bone bruise of the femoral condyle. Rubin DA, Kettering JM, Towers JD, Britton CA: MR imaging of knees having isolated and combined ligament injuries. 2, Fig. The knee is a synovial joint formed by the femoral condyles articulating with the tibial condyles (figs 1 and 2). Fracture DataRelative frequencies of fractures Most frequently overlookedto the knee in adults fractures in an ED1. It is also known as Osteochondritis Dissecans and is common in the knee joint, especially in association with other injuries such as ACL tears. OCD usually causes pain during and after sports. It is important … The talus is the 3rd most common site (after the knee and elbow) of osteochondral lesions. Chondral and osteochondral injuries were the most common lesions discovered in children undergoing MRI for evaluation of internal derangement of the knee in one study . In adolescence, the cartilage‐bone interface is the weakest transitional area in the knee joint, and there is no obvious boundary between calcified and uncalcified cartilage 2. Rubin DA: Magnetic resonance imaging of chondral and osteochondral injuries. The biomechanical strength of immature osteochondral junction was lower than that of mature osteochondral junction. The accuracy of magnetic resonance imaging scanning and its influence on management decisions in knee surgery. The abnormality is seen as as a scooped-out defect or linear fracture in the articular cartilage on arthrography; on arthroscopy the findings are similar, though the fracture may appear stellate in cases of a direct blow to the knee. The fracture healed after 3 months and the knee was stable. Less frequently patellar fractures may follow total knee replacement (0.68%) (see Fig. An osteochondral fracture is a type of fracture in which the articular cartilage at the end of a joint becomes torn. The large osteochondral defect was eventually managed in a staged manner with bone grafting and osteochondral autograft transfer. In 21 patients (44%), MRI confirmed osteochondral injury despite the plain radiograph interpretation as negative for fracture. Magnetic resonance imaging (MRI) is necessary to fully characterize the size, shape, and location of the osteochondral fracture fragment and to help the surgeon predict suitability for fixation (Figs 1 and 2). Tibial plateau (16%)2. X-rays of the knee joint are requested frequently, particularly at the Emergency Assistance department. Osteochondral fracture of the lateral femoral condyle is a rare injury of the knee joint, which mostly occurs in adolescence 1. The only half pathology isminutia, but we areresponsible for the big the Maissoneuvre fx (seestuff… ankle radiology) 11. 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