Materiały źródłowe

• #1

  https://journals.lww.com/jbjsjournal/fulltext/2021/06160/osteochondritis_dissecans__current_understanding.11.aspx

  Osteochondritis dissecans occurs most frequently in the active pediatric and young adult populations, commonly affecting the knee, elbow, or ankle, and may lead to premature osteoarthritis. […] Clinical practice guidelines have been limited by a paucity of high-level evidence, but a multicenter effort is ongoing to develop accurate and reliable classification systems and multimodal decision-making algorithms with prognostic value.

• #2 (PDF) Osteochondritis dissecans of the knee: Epidemiology, etiology, and natural history

  https://www.academia.edu/107271210/Osteochondritis_dissecans_of_the_knee_Epidemiology_etiology_and_natural_history

  Osteochondritis dissecans of the knee is a disease that typically affects skeletally immature patients. […] Although being a rare condition, its awareness is of utmost clinical interest because of the possible severe consequences it can bring when misrecognized or inadequately treated. […] This review article aims to deliver and discuss current and up-to-date concepts on epidemiology, etiology, and natural history of this pediatric condition. […] Osteochondritis dissecans is a condition primarily found in the knee, elbow, and ankle, which affects subchondral bone and potentially the overlying articular cartilage. […] The etiology, presentation, and management is age-dependent, as osteochondral lesions have a much greater potential to heal when those affected are skeletally immature. […] The demographics and epidemiology of osteochondritis dissecans of the knee in children and adolescents. […] Descriptive epidemiology from the research in osteochondritis dissecans of the knee (ROCK) prospective cohort.

• #3 Osteochondritis Dissecans | Concise Medical Knowledge

  https://www.lecturio.com/concepts/osteochondritis-dissecans/

  Osteochondritis dissecans (OCD) is an orthopedic disorder characterized by the detachment of a focal segment of subchondral bone and cartilage as a result of focal aseptic necrosis. This can occur at any age, but it is most commonly seen in adolescents who participate in competitive sports. […] Prevalence: 1529 per 100,000 patients. […] Peak age: 12-19 years. […] Higher incidence in young athletes.

• #4 Osteochondritis dissecans – Wikipedia

  https://en.wikipedia.org/wiki/Osteochondritis_dissecans

  OCD is a relatively rare disorder, with an estimated incidence of 15 to 30 cases per 100,000 persons per year. […] Although rare, OCD is noted as an important cause of joint pain in active adolescents. […] The juvenile form of the disease occurs in children with open growth plates, usually between the ages 5 and 15 years and occurs more commonly in males than females, with a ratio between 2:1 and 3:1. […] OCD has become more common among adolescent females as they become more active in sports. […] The adult form, which occurs in those who have reached skeletal maturity, is most commonly found in people 16 to 50 years old. […] While OCD may affect any joint, the knee specifically the medial femoral condyle in 75-85% of knee cases tends to be the most commonly affected, and constitutes 75% of all cases. […] The elbow (specifically the capitulum of the humerus) is the second most affected joint with 6% of cases; the talar dome of the ankle represents 4% of cases.

• #5

  https://step1.medbullets.com/msk/107061/osteochondritis-dissecans

  Epidemiology […] incidence […] rare […] 15-29 cases per 100,000 patients […] demographics […] males females […] age […] 10-20 years of age […] risk factors […] African American race […] repeated trauma and overuse […] […] […] Prognosis […] skeletally immature patients are more likely to have a complete recovery than skeletally mature patients […] patients with less severe lesions are more likely to have a complete recovery

• #6 Osteochondritis Dissecans (Causes, Symptoms, and Treatment)

  https://patient.info/doctor/osteochondritis-dissecans

  OCD most often affects the knee. The exact prevalence of OCD is unknown but prevalence figures of between 15 and 29 per 100,000 have been reported. OCD is more common in males. […] Osteochondritis dissecans most commonly affects the knee joint (75% of cases). About 85% of knee lesions are on the medial femoral condyle. […] Osteochondritis dissecans can affect more than one site and may be bilateral in 20-30% of cases.

• #7 Osteochondritis Dissecans

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8272630/

  OCD is divided into juvenile and adult forms, depending on skeletal maturity at diagnosis. […] Adult OCD has an incidence rate of 3.42 per 100,000 person-years and predominantly affects ankles, followed by knees. […] Juvenile OCD is more common, affecting 9.5 to 29 of 100,000 knees, 2.2 of 100,000 elbows, and 2 to 4.6 of 100,000 ankles. […] Clinically apparent OCD is rare in patients who are 10 or 50 years old. […] The risk of juvenile OCD is higher in patients who are 12 years old than in those between 6 and 11 years old and is 3 times higher in knees, 22 times higher in elbows, and 7 times higher in ankles in the older children than in the younger group. […] Boys have more risk of developing OCD in the knee (4 times) and elbow (7 times), whereas girls have more risk of OCD developing in the talus (1.5 times).

• #8

  https://www.orthobullets.com/evidence/24272456

  Osteochondritis dissecans (OCD) is a disorder of subchondral bone and articular cartilage whose incidence in children is not clearly known. […] The purpose of this study was to assess the demographics and epidemiology of OCD of the knee in children. […] A retrospective chart review of an integrated health system was performed on patients with OCD of the knee aged 2 to 19 years from 2007 to 2011, with over 1 million patients in this cohort. […] The incidence of patients with OCD of the knee aged 6 to 19 years was 9.5 per 100,000 overall and 15.4 and 3.3 per 100,000 for male and female patients, respectively. […] In this population-based cohort study of pediatric OCD of the knee, male patients had a much greater incidence of OCD and almost 4 times the risk of OCD compared with female patients. Also, patients aged 12 to 19 years had 3 times the risk of OCD of the knee as compared with 6- to 11-year-old children.

• #9 Osteochondritis Dissecans: A Diagnosis Not to Miss | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/0101/p151.html

  Osteochondritis dissecans is the most common cause of a loose body in the joint space in adolescent patients. […] The incidence of OCD in the general population is estimated to be 15 to 30 cases per 100,000 persons. […] Although rare, it is recognized as an important cause of joint pain in active adolescents. […] OCD has typically been known to affect males between 10 and 20 years of age. […] One study noted that boys are three to four times as likely to be affected as girls. […] The incidence appears to be increasing in women and in younger children, perhaps because of increasing involvement in organized sports. […] The most commonly affected areas include, in decreasing order of frequency, the femoral condyles, talar dome and capitellum of the humerus. […] The knee is involved about 75 percent of the time. […] Classically, the nonweight-bearing medial femoral condyle is the location in 85 percent of cases of OCD of the knee. […] OCD must be ruled out in the contralateral joint, because 20 to 30 percent of cases are bilateral.

• #10 Osteochondritis dissecans – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/osteochondritis-dissecans/symptoms-causes/syc-20375887

  Osteochondritis dissecans occurs most often in children and adolescents. […] Osteochondritis dissecans occurs most commonly in children and adolescents between the ages of 10 and 20 who are highly active in sports.

• #11 Understanding Osteochondritis Dissecans: A Narrative Review of the Disease Commonly Affecting Children and Adolescents

  https://www.mdpi.com/2227-9067/11/4/498

  The results of the ROCK group’s analysis of a multicenter prospective cohort indicated that the most commonly found OCD lesions are located in the knee and elbow, specifically in medial femoral condyle (66.2%), followed by the lateral femoral condyle (18.1%), trochlea (9.5%), patella (6.0%), and tibial plateau (0.2%). Ankle OCD is less common with lesions located in the posteromedial (71.8%), anterolateral (22.4%), or central (3.5%) regions of talus. […] According to the literature, the prevalence of knee OCD ranging from 2.3 to 31.6 cases per 1000,000 population. The highest prevalence is observed in juveniles and reaches 11.2 per 100,000 in the 12-to-16-year-old age group. The multivariable logistic regression analysis indicated a 3.3-fold increased risk of knee OCD in patients aged 12 to 19 years compared to those aged 6 to 11 years (p < 0.001). Moreover, male patients exhibited a 3.8-times-higher risk of knee OCD than females (p < 0.001). Most cases of knee OCD involved multisport athletes, with a particularly high prevalence among male basketball players and female soccer players.

• #12 511670 | Stanford Health Care

  https://stanfordhealthcare.org/v2/publications/511/511670.html

  Osteochondritis dissecans (OCD) of the elbow is a disorder of subchondral bone and articular cartilage, of which the incidence among children is not clearly known. To assess the demographics and epidemiology of OCD of the elbow among children. A total of 37 patients with 40 OCD lesions fit the inclusion criteria. The incidence of elbow OCD for patients aged 6 to 19 years was 2.2 per 100,000 overall and 3.8 and 0.6 per 100,000 for males and females, respectively. The majority of OCD cases were seen in those aged 12 to 19 years, with an incidence of 3.4 per 100,000 versus 0.38 among 6- to 11-year-olds. Multivariable logistic regression analysis revealed a 21.7-times increased odds ratio of elbow OCD among patients aged 12 to 19 years versus 6 to 11 years, and males had a 6.8-times greater odds ratio of elbow OCD than females. Based on race and ethnicity, non-Hispanic whites had the highest incidence of elbow OCD as compared with all other ethnic groups. In this population-based cohort study of pediatric elbow OCD, males had almost 7 times the risk of elbow OCD as compared with females, and 12- to 19-year-olds had nearly 22 times the risk of elbow OCD versus 6- to 11-year-olds.

• #13 Understanding Osteochondritis Dissecans: A Narrative Review of the Disease Commonly Affecting Children and Adolescents

  https://www.mdpi.com/2227-9067/11/4/498

  Concerning elbow OCD, data from the United States showed an incidence of capitellar OCD at 6.0 per 100,000 in the general population, 9.5 per 100,000 for male patients, and 2.6 per 100,000 for female patients. The incidence was particularly elevated in younger patients. Among the affected individuals, 89% were engaged in sports, with 90% being overhead athletes and 58% identified as throwing athletes. […] The frequency of ankle OCD in individuals between 6 and 19 years old was overall 4.6 cases per 100,000. Specifically, the rates were 3.2 per 100,000 in male patients and 6.0 per 100,000 in female patients. Additionally, a multivariate logistic regression analysis indicated that the risk of ankle OCD was 6.9 times higher in patients aged 12 to 19 years compared to those aged 6 to 11 years.

• #14 Osteochondritis dissecans | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/osteochondritis-dissecans?lang=us

  Onset is between childhood and young adulthood, with the majority of patients being between 10 and 40 years of age. There is a male to female ratio of ~2:1. […] Repetitive throwing / valgus stress and gymnastics / weight-bearing on upper extremity: valgus stress / compressive force on the vulnerable chondroepiphysis of the radiocapitellar joint in skeletally immature patients is supported as the etiology for osteochondritis dissecans of the capitellum. […] Competitive athletics. […] Family history: epiphyseal dysplasia has been postulated as a subset of osteochondritis dissecans.

• #15 An update on osteochondritis dissecans of the knee | Published in Orthopedic Reviews

  https://orthopedicreviews.openmedicalpublishing.org/article/38829

  Osteochondritis dissecans of the knee (OCD) is a multifactorial pathology in where repetitive microtrauma plays a central role in the etiopathogenesis. […] The incidence of JOCD of the knee ranges from 2.3 to 31.6 cases out of 100.000, with an increasing incidence due to greater use of MRI and arthroscopy in the pediatric population, early competitive activity and intensive training. It mainly affects young males, with a male-to-female ratio of 5:3, mainly between the ages of 11 and 20. […] Ultimately, the microtraumatic theory plays a central role in the etiopathogenesis of the OCD, despite being a multifactorial pathology. […] The prognosis also depends on site of the lesions: medial femoral condylar lesions has a good prognosis, instead patellar lesions have a poor prognosis, probably due to a higher rate of fragment instability.

• #16 – Osteochondritis Dissecans: Overview, Epidemiology, Etiology, Classification, Assessment | Obgyn Key

  https://obgynkey.com/osteochondritis-dissecans-overview-epidemiology-etiology-classification-assessment/

  Historically, there has been a distinction between juvenile-onset OCD and adult-onset OCD. […] There are only three true epidemiology papers regarding knee OCD. […] A classic study by Linden in 1977 from Malmo, Sweden demonstrated an incidence of 29 per 100,000 boys and 19 per 100,000 girls. […] The only other study was published in 2014 and included a review of just over 1 million children aged 2 to 19 years within a closed health system. […] The incidence of knee OCD varied by ethnicity: non-Hispanic white was 10.3 per 100,000 overall, non-Hispanic black was 10.3 per 100,000 overall, Hispanic was 8.6 per 100,000 overall, and Asian was 4.7 per 100,000 overall. […] Finally, there is the discrete possibility that knee OCD may occur in both knees.

• #17 Osteochondritis Dissecans | PM&R KnowledgeNow

  https://now.aapmr.org/osteochondritis-dessicans/

  OCD affects adolescents at a rate around 10 per 100,000. It is more common among males and African American race. The highest incidence of juvenile OCD is among patients 10 to 15 years old. OCDs are significantly more common in the knee (75% or more of cases), followed by the elbow (6% of cases) and ankle (4% of cases). The most common location for juvenile OCD of the knee is the lateral portion of the medial femoral condyle (60-70%) followed by the lateral femoral condyle (15-20%). A large percentage of patients with OCD self-identified as athletes (91.4%), and the majority of those patients were multisport athletes; suggesting that increased physical activity may be a risk factor. […] Multiple missense ACAN gene variants with autosomal dominant inheritance, affect the C-type lectin repeat of aggrecan (15q gene) and cause a rare form of hereditary osteochondritis dissecans. ACAN missense gene variants are often demonstrate short stature and early osteoarthritis.

• #18 Osteochondritis Dissecans

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8272630/

  OCD predilection sites differ for each joint. […] The classic site of knee OCD is the posterior-central aspect of the medial condyle (63.6% to 85%) compared with inferior-central aspect of the lateral condyle (15% to 32.5%), inferomedial aspect of the patella (1.5% to 10%), and trochlea (2%). […] Elbow OCD typically affects the anterolateral or central aspect of the capitellum (97.5%) rather than the trochlea (2.5%). […] Most OCD lesions of the talus are posteromedial (71.8%) and are less frequently anterolateral (22.4%) or central (3.5%). […] OCD usually involves a single site but can be multifocal within one or multiple joints with lesions in different stages. […] Bilateralism occurs in knees (7.3% to 29%) and elbows (8.1%), and is rare in ankles. […] OCD tends to affect active children and young adults.

• #19 Knee Hemarthros Secondary to Osteochondritis Dissecans (König Disease) | Reumatología Clínica

  http://www.reumatologiaclinica.org/en-hemartrosis-rodilla-secundaria-osteocondritis-disecante-articulo-resumen-S2173574315000891

  Osteochondritis dissecans (OCD), or Knig disease, is a rare form of osteochondrosis in which, as a consequence of the necrosis of a small fragment of subchondral bone, the bone sequestrum and the articular cartilage that covers it ultimately break loose from the adjacent bone and cartilage, and become lodged in the joint as a loose body. A prevalence of less than 0.1% has been established among children participating in sports and the prevalence in the general population is unknown, whereas the incidence is estimated to be between 1.5 and 1.6 new cases per 100 000 population/year. […] Although the pathophysiology is not fully understood, it is considered to be a consequence of a vulnerable subchondral area being subjected to repetitive microtrauma. It is for this reason that its prevalence appears to be higher among children than among adults. […] Osteochondritis dissecans affects the posterolateral aspect of the medial femoral condyle in approximately 70% of the cases and the inferocentral portion of the lateral condyle in 10%20%, whereas the sum of other sites represents less than 1% of the cases.

• #20 Osteochondritis Dissecans – Knee | Pediatric Orthopaedic Society of North America (POSNA)

  https://posna.org/physician-education/study-guide/osteochondritis-dissecans-knee

  Incidence reported around 9/100,000 in children under 11 years old and 22/100,000 in adolescents 12-19 years old. […] Boys have a higher incidence then girls. […] Reported incidence is on the rise. […] Lesions are bilateral approximately 25% of the time. […] Adult OCD lesions are thought to be persistent or untreated juvenile OCD lesions, though de novo adult lesions have been described.

• #21 Understanding Osteochondritis Dissecans: A Narrative Review of the Disease Commonly Affecting Children and Adolescents

  https://www.mdpi.com/2227-9067/11/4/498

  Yellin et al. examined the medical records of 80 patients aged ≤18 years diagnosed with unilateral knee OCD. Contralateral knee imaging of the asymptomatic knee, performed within 1 year of the initial presentation (a routine practice for several physicians in the group), was necessary to identify asymptomatic contralateral knee lesions. The study revealed that 15% of patients exhibited bilateral disease, with no significant distinctions in age, sex, physical status, or lesion characteristics between those with unilateral versus bilateral conditions.

• #22 Osteochondritis Dissecans

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8272630/

  Participation in high-level athletics is associated with the development of OCD in the knee (55% to 60%), elbow (84%), and talus (67.4%). […] Interestingly, children with extreme obesity have more risk for the development of elbow and talar OCD, whereas moderate obesity increases the risk of knee OCD. […] An observed trend of younger onset of OCD may be related to earlier sports participation or specialization and increasing childhood obesity.

• #23 Osteochondritis Dissecans | PM&R KnowledgeNow

  https://now.aapmr.org/osteochondritis-dessicans/

  Recent studies have shown that Vitamin D deficiency was associated with knee osteochondritis dissecans lesions among the young adult population. Increased BMI is associated with more severe lesions: subchondral edema, anteromedial condylar lesions of the knee. Discoid menisci and valgus alignment have been shown to be a risk factor for lateral femoral condyle OCD. […] Overhead throwing and upper limb weightbearing is associated with OCD of the elbow, as seen in baseball pitches, softball pitchers, cheerleaders, cricket bowlers, cheerleaders, female gymnastics. […] Medial talar dome lesions are often the result of vascular disease and chronic ankle instability lesions, lateral talar dome is associated with acute trauma and lateral ankle ligament injury.

• #24 Descriptive Epidemiology From the Research in Osteochondritis Dissecans of the Knee (ROCK) Prospective Cohort. | EBSCOhost

  https://search.ebscohost.com/login.aspx?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=03635465&AN=154542921&h=j8Sc6MIs9aveSlZVJLghfkXgM%2B6w0DPpNIu6YD2GAbATd32XEsBFehYZc5aSy3dZpr7JBSYExiLZEWY05476Ow%3D%3D&crl=f

  Descriptive Epidemiology From the Research in Osteochondritis Dissecans of the Knee (ROCK) Prospective Cohort. […] Osteochondritis dissecans (OCD) occurs most commonly in the knees of young individuals. […] The Research in Osteochondritis Dissecans of the Knee (ROCK) group established a multicenter, prospective cohort to better understand this disease. […] As of November 2020, a total of 27 orthopaedic surgeons from 17 institutions had enrolled 1004 knees with OCD, representing 903 patients (68.9% males; median age, 13.1 years; range, 6.3-25.4 years), into the prospective cohort. […] The multicenter ROCK group has been able to enroll the largest knee OCD cohort to date. […] This information is being used to further understand the pathology of OCD, including its cause, associated comorbidities, and initial presentation and symptoms.

• #25 Osteochondritis Dissecans: Knee Joint Cartilage Pain | HSS

  https://www.hss.edu/condition-list_osteochondritis-dissecans-knee.asp

  Osteochondritis dissecans most often affects the knees of young people. It is most prevalent between 10 and 18 years old. […] Descriptive Epidemiology From the Research in Osteochondritis Dissecans of the Knee (ROCK) Prospective Cohort. Am J Sports Med. 2022 Jan;50(1):118-127. doi: 10.1177/03635465211057103. Epub 2021 Nov 24. PMID: 34818065.

• #26 Top Published Expert Doctors for Osteochondritis Dissecans

  https://findexpertmd.com/d/Osteochondritis_Dissecans

  379 top medical experts on Osteochondritis Dissecans across 36 countries and 36 U.S. states, including 305 MDs (Physicians). This is based on an objective analysis of their Scientific Publications, Clinical Trials, Medicare, and NIH Grants. […] Clinical Trials: at least 25 including 4 Active, 6 Completed, 5 Recruiting.

• #27

  https://journals.lww.com/jbjsjournal/fulltext/2021/06160/osteochondritis_dissecans__current_understanding.11.aspx

  Osteochondritis dissecans occurs most frequently in the active pediatric and young adult populations, commonly affecting the knee, elbow, or ankle, and may lead to premature osteoarthritis. […] Clinical practice guidelines have been limited by a paucity of high-level evidence, but a multicenter effort is ongoing to develop accurate and reliable classification systems and multimodal decision-making algorithms with prognostic value.

• #28 Osteochondritis dissecans – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/591

  Osteochondritis dissecans is an idiopathic lesion of subchondral bone. […] Majority of patients are adolescent or young adult athletes. Main joints involved include the knee, ankle, and radiocapitellar joint of the elbow. Bilateral in up to 25%. […] It is increasingly seen as the cause of joint pain in adolescent and young adult athletes, thought to be due to earlier and higher-demand participation in competitive sport. However, no clear evidence is available to support this belief, and despite much speculation the cause of both juvenile and adult osteochondritis dissecans remains unclear.

• #29 Osteochondritis Dissecans | Musculoskeletal Key

  https://musculoskeletalkey.com/osteochondritis-dissecans/

  Osteochondritis dissecans (OCD) is classically divided into juvenile and adult forms on the basis of the patient skeletal maturity. […] The highest incidence rates in juvenile OCD appear among patients between 10 and 15 years old, ranking among the most common causes of knee pain and dysfunction in young adults. […] The prevalence of OCD is estimated at 15 to 21 per 100,000. […] Most adult OCD cases arise from established untreated or unrecognized juvenile OCD. […] A large multicenter review of the European Pediatric Orthopedic Society study suggests an improved prognosis with conservative treatment in young patients with a small lesion (2 cm2) in the classic location with no signs of dissection or effusion.

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