- Osteochondritis dissecans is a condition of the joints that appears to affect subchondral bone primarily, with secondary effects on articular cartilage
- Osteochondritis Dissecans of the knee has been a disorder in which proper treatment guidelines have not been established
- Several aetiologies like, family history, repetitive micro-trauma, growth disorders, and ischemia—have been proposed
- One study identified the incidence of OCD as 29 cases per 100,000 males and 18 cases per 100,000 females.
- The AAOS has issued guidelines by conducting reviews of high quality articles that were published between 1996 and 2010
- The workgroup formulated the following treatment guidelines after researching through these articles
- Symptomatic skeletally immature patients with loose or completely detached lesions should be offered surgery as an option. There is, however, no evidence for any particular kind of surgery;
- Patients who remain symptomatic after treatment for OCD should have a repeat history and physical examination, X-rays, and/or MRI to assess healing;
- Patients who receive surgical treatment of OCD should be offered postoperative physical therapy.
- The working group is unable to recommend for or against counseling patients about whether activity modification and weight control prevents onset and progression of OCD to osteoarthritis (osteoarthrosis)
- Even undertaking this research on evaluating the recommendation of OCD of the knee, the AAOS working group believes that are a lot of areas that needs further research.
- The following were described as the areas where further research would be necessary:-
- Inter- and intraobserver reliability studies on lesion classification for radiographs, MRI, and arthroscopy.
- Prospective cohort studies of knee OCD lesions treated nonsurgically should be conducted to identify the independent predictors of success of nonsurgical management of an OCD lesion.
- Randomized controlled trials should be conducted to establish the optimal physical therapy and nonsurgical treatment strategies and physical therapy interventions for patients with OCD of the knee.
- Randomized controlled trials should be conducted to establish the optimal surgical treatment strategies for OCD of the knee.
- Randomized controlled trials should be conducted to determine the optimal postoperative management of patients with OCD of the knee.
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