Background: In 1967, Wilson described a clinical sign that he thought was diagnostic of medial femoral osteochondritis dissecans. He postulated that impingement of the tibial eminence on the osteochondritic lesion caused pain and a resultant compensatory lateral rotation during gait. He described reproducing the pain by internally rotating the patient's tibia during knee extension between 90 degrees and 30 degrees of flexion and then relieving that pain by externally rotating the tibia. He correlated healing of the lesion with conversion of the sign from positive to negative.
Purpose: To assess the validity of Wilson's assertions.
Study Design: Retrospective clinical and radiographic case analysis.
Methods: Case records from 17 juvenile patients (ages 9 to 12) and 15 adolescent patients (ages 13 to 17) with medial femoral osteochondritis dissecans were reviewed for the presence or absence of Wilson's sign at initial and subsequent visits.
Results: Of the 32 patients, 24 (75%) with radiographically evident osteochondritis dissecans at the initial visit had negative signs. The remaining eight patients with positive signs had conversion of the sign to negative with lesion resolution.
Conclusions: In this series, Wilson's sign was of minimal clinical diagnostic value. When positive, the sign is useful as a clinical monitor during treatment.
A 13-year-old boy was referred to orthopedic surgery for chronic intermittent pain and swelling of the left knee. Initial imaging was consistent with osteochondritis dissecans of the femoral condyle. Follow-up imaging demonstrated unexpected progression, with a mass extending into the notch, replacing the anterior cruciate ligament, and eroding the femoral and tibial condyles.
Background: There are limited evidence-based guidelines to predict which osteochondritis dissecans (OCD) lesions will heal with nonoperative treatment.
Purpose: To train a set of classification algorithms to predict nonoperative OCD healing while identifying new clinically meaningful predictors.
Study Design: Case-control study; Level of evidence, 3.
Introduction: Management of osteochondritis dissecans (OCD) lesions of the capitellum is challenging. Historically, variability exists between surgeons in the evaluation, treatment, and return to sport criteria. The purpose of this study was to define the current trends regarding evaluation, nonoperative and surgical management, and return to sport criteria for capitellar OCD lesions among surgeons.
Similar to other fields, there is growing evidence of disparities in pediatric sports medicine. For children and adolescents with knee injuries, disparities persist along the lines of sex, gender, race, ethnicity, insurance, socioeconomic status, and other determinants. These factors influence the evaluation, treatment, and outcomes for a variety of knee pathologies, including anterior cruciate ligament ruptures, meniscus tears, osteochondritis dissecans, cartilage injuries, and tibial spine fractures.
