Musculoskeletal disorders, standing as the fifth leading cause of disability-adjusted life years globally, present significant challenges in orthopedics. Osteochondritis dissecans (OCD) and avascular necrosis (AVN) are distinct but closely related conditions within this spectrum, impacting patients' quality of life with pain, limited mobility, and dysfunction. OCD, involving cartilage and bone detachment in joints, predominantly affects young athletes, but its exact etiology and optimal management remain subjects of ongoing research. Conversely, AVN, marked by bone tissue death due to compromised blood supply, is linked to systemic factors like corticosteroid use and traumatic injuries. Diagnosis for both conditions relies on radiography and magnetic resonance imaging. Conservative treatment for AVN includes the use of a cane or crutches, pharmacological therapy, or physical therapy. On the other hand, in OCD, the primary approach is activity/sports restriction. Surgical treatment options for AVN patients encompass core decompression, bone grafting, or, in the most advanced cases, total hip arthroplasty. OCD may be surgically treated through subchondral drilling or fixation of unstable lesions. Advanced cases of OCD involve cartilage salvage with resurfacing techniques. The presentation of differences between these conditions enhances our understanding, facilitating improved diagnosis and management strategies.
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http://dx.doi.org/10.3390/jcm13010287 | DOI Listing |
Am J Sports Med
January 2025
Department of Orthopedic Surgery, Scripps Clinic, La Jolla, California, USA.
Background: Fresh osteochondral allograft (OCA) transplantation is an established treatment option for patients with chondral or osteochondral lesions of the knee. Predictably positive outcomes are seen in situations of focal or isolated cartilage defects. However, OCA transplantation may also be performed in more complex joint salvage situations in young patients.
View Article and Find Full Text PDFJSES Rev Rep Tech
February 2025
Department of Orthopaedic Surgery, Elbow Shoulder Research Centre (ESRC), University of Kentucky, Lexington, KY, USA.
J Shoulder Elbow Surg
January 2025
Lerner Children's Pavilion, Hospital for Special Surgery, New York, NY, USA. Electronic address:
Background: Humeral capitellar osteochondritis dissecans (OCD) lesions can be challenging to treat. Past studies have demonstrated grafting with extracellular matrix with bone marrow aspirate concentrate (ECM-BMAC) to be a viable technique for treatment of talar dome OCD, though little literature exists regarding application of this technique to the capitellum. This study aimed to report patient-reported outcomes (PROs) and return to sport (RTS) of pediatric patients at ≥1-year postoperatively who underwent ECM-BMAC grafting for capitellar OCD lesions.
View Article and Find Full Text PDFOrthop J Sports Med
January 2025
Department of Orthopaedic Surgery, Carthage Area Hospital, Carthage, New York, USA.
Background: While glenoid bone loss (GBL) after anterior shoulder instability correlates with poor functional outcomes, the specific effects of GBL in posterior and combined-type shoulder instability remain poorly characterized, especially in a high-risk military population.
Purpose/hypothesis: The purpose of this study was to compare GBL between unidirectional anterior or posterior instability versus combined-type instability in active-duty servicemembers. It was hypothesized that total GBL and GBL in the direction of instability would be greater in those with combined-type instability compared with unidirectional instability.
Orthop J Sports Med
January 2025
Department of Orthopaedic Surgery, Hyogo Medical University, Nishinomiya, Hyogo, Japan.
Background: Functional recovery and return to sports after fixation of osteochondritis dissecans (OCD) lesions of the knee with osteochondral autologous transplantation (OAT) have not been well investigated.
Purpose: To retrospectively evaluate the functional recovery and clinical outcomes after internal fixation with OAT for knee OCD.
Study Design: Case series; Level of evidence, 4.
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