The typical MRI findings after transient lateral dislocation of the patella have been well described and include a bone contusion pattern involving the inferomedial pole of the patella and the anterolateral aspect of the nonarticular portion of the lateral femoral condyle. Transient lateral patellar dislocation is a common injury that typically occurs in the young, athletic individual. Two donor plugs were harvested from this region, measuring 10 × 14 mm and 6 × 14 mm, respectively. Osteochondral defects of the lateral femoral condyle are a common sequela after transient lateral patellar dislocation. 18 Acute Osteochondral Defects in the Knee JOHN G. COSTOUROS, MARC R. SAFRAN, AND GREGORY B. MALETIS Despite surgical and technologic advancements, the treatment of osteochondral defects continues to challenge orthopaedic surgeons. Knee pain. This is frequently seen following patellar dislocation, patellar fracture, or in the setting of osteochondritis dissecans lesions. There are various techniques to make a tunnel image. About Dr. Sumer Sethi Number of Entries : 35. Objective: The typical bone bruise pattern involving the anterolateral femoral condyle and inferomedial patella after transient lateral dislocation of the patella is a well-described MRI finding. Osteochondral fractures of the patella are commonly associated with acute patellar dislocations. There is an articular cartilage defect at the medial patellar facet with adjacent bone marrow edema. She was seen in the emergency room after suffering an accidental fall, assessed as an osteochondral fracture-dislocation of the right patella with upper-outer displaced free fragments. Perhaps, the only potential differential diagnosis is a dorsal defect of the patella, which occur in the superolateral aspect of the patella, whereas OCD more commonly occurs in the inferomedial aspect of the patella with abnormal articular cartilage.Â, ADVERTISEMENT: Supporters see fewer/no ads. Tags : MRI Musculoskeletal MRI Musculoskeletal radiology. Osteochondral Defect is the name given to a condition most noticeable in the knee, in which a part of the bone and cartilage gets separated from the knee joint resulting in chronic pain in the knee and difficulties performing normal activities of daily living. These can occur from an acute traumatic injury to the knee or an underlying disorder of the bone. Bildgebendes Verfahren der Wahl ist die MRT-Untersuchung, da sich selbst größere osteochondrale Fragmente der konventionellen Röntgenbildgebung entziehen können. A T1W sagittal image of the left knee shows an osteochondral defect (arrow) in the medial patellar facet with accompanied bone marrow oedema and the thickened, heterogeneous and fissured overlying cartilage. MRI evaluation showed some abnormal findings with the presence of bone overgrowth, but no correlation has been … {"url":"/signup-modal-props.json?lang=us\u0026email="}. All these cases presented ICRS stage IV osteochondritis dissecans with an empty defect lesion. It is unusual that the osteochondral patellar defect site in this patient was in the inferior and central areas of the patella. Osteochondral defect of the lateral femoral condyle is common sequela after lateral patellar dislocation, mostly involving the non-weight-bearing portion of the antero-lateral aspect of the condyle. Unable to process the form. These findings are essential in diagnosis … Osteochondral defects of the latera l femoral condyle are a common se- quela after transient lateral patellar dislocation. One commonly used technique is the axial projection. Typical findings of prior lateral patellar dislocation: medial patellofemoral ligament tear at the patellar and femoral attachment with osteochondral avulsion fracture at the inferomedial patellar margin; two intraarticular chondral fragments; extensive chondral lesion of the antero- and centrolateral femoral condyle; traumatic changes of the Hoffa fat pad Radiology. The implantation of a cell-free collagen-hydroxyapatite osteochondral scaffold provided a clinical improvement at short-term follow-up for the treatment of patellar cartilage defects. A dorsal defect of the patella is a variant related to normal ossification, present in 0.3 to 1 % of the population, located in the superolateral aspect of the articular surface of the patella. Femoral trochlea is normal. X-rays pass through the knee from anterior to posterior at a 90° angle to the lower leg. 1 The knee joint is perhaps one of the busiest joints in the body as it bears most of the body weight when standing. The medial location of the lesions and the involvement of the system of medial knee stability is a fundamental finding. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Dorsal defect of the patella. tella described chondral defects of the patella but made no mention of chondral injuries of the lateral femoral condyle [1–5]. Patellar osteochondral fracture is an injury frequently associated with patellar instability, which may onset in the first episode. Chondral and osteochondral defects in the PF compartment are often encountered in clinical practice on advanced imaging studies and/or during arthroscopy. Conclusion: The implantation of a cell-free collagen-hydroxyapatite osteochondral scaffold provided a clinical improvement at short-term follow-up for the treatment of patellar cartilage defects. A significant number of osteochondral injuries involve the midlateral weight-bearing portion of the lateral femoral condyle and are more posterior than would be expected after transient dislocation of the patella. The word osteochondral refers to anything relating to cartilage and bone. Acute lateral patellar dislocation at MR imaging: injury patterns of medial patellar soft-tissue restraints and osteochondral injuries of the inferomedial patella. Acute lateral patellar dislocation at MR imaging: injury patterns of medial patellar soft-tissue restraints and osteochondral injuries of the inferomedial patella. ADVERTISEMENT: Supporters see fewer/no ads. The MENDER II is then inserted from the anterior aspect to the intra-articular surface to retrieve the sutures. Osteochondral or chondral loose bodies that result from recurrent patella instability or from longstanding OCD in skeletally mature patients may not be repairable. stage I. injury limited to articular cartilage; MRI findings: subchondral edema; x-ray findings: none; stage II. In our study, however, we sought to determine the incidence and location of lateral femoral condyle osteochondral injuries after transient lateral dislocation of the patella. Patellar chondral fractures without dislocation or patella fracture are rare. Osteochondral defects of the lateral femoral condyle are a common sequela after transient lateral patellar dislocation. There is an osteochondral fragment floating within the suprapatellar bursa which is isointense with bone structures in all sequences. MRI features that aid in diagnosis include the location and extent of bone marrow edema, the presence of a fracture line, a hypointense area immediately subjacent to the subchondral bone plate, and deformity of the subchondral bone plate. {"url":"/signup-modal-props.json?lang=us\u0026email="}. Your thighbone (femur), shinbone (tibia), and kneecap (patella) fit tightly together and move smoothly because the bone surface is covered with a thick coating of articular (hyaline) cartilage. cartilage injury with associated subchondral fracture but without detachment; thin sclerotic margin The bone marrow edema at lateral femoral condyle and grade II medial patellar retinaculum injury secondary to lateral patellar dislocation. 4.8a–c. Radiographic features Patellar osteochondral fractures with no dislocation are uncommon and usually affect the centromedial facet of the patella. Acute patellar dislocation (APD) is associated with a spectrum of soft tissue and osteochondral injuries. Check for errors and try again. Based on multiple studies demonstrating similar functional outcomes after both conservative and operative procedures for treatment of APD, Conservative treatment has been traditionally the preferred option for APD without an osteochondral fracture (OCF) [1,2,3,4,5,6,7,8]. Knee > Osteochondral Defect What is Osteochondral Defect? It was decided to use the superomedial aspect of the trochlea as the donor sight for the osteochondral autograft. Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management. Unique blend of academic excellence and entrepreneurship, heading leading firms in India- Teleradiology Providers, pioneering company … An osteochondral defect refers to a focal area of damage that involves both the cartilage and a piece of underlying bone. The defect was debrided down to the subchondral bone with an arthroscopic shaver and sized with the osteochondral autograft transplantation system, as shown in Fig. Open reduction internal fixation of chondral defects should be attempted when a large chondral fragment with bone is present. Introduction. Check for errors and try again. The treatment of focal cartilage defects of the patella is a major challenge in the field of cartilage repair. It is bilateral in up to one-third of individuals. Conclusion: Osteochondral defects of the lateral femoral condyle are a common sequela after transient lateral patellar dislocation. Indirect signs include hemarthrosis, contusion or osteochondral injury of the medial patellar facet and lateral femoral condyle, and injury to the medial patellar retinaculum (Fig. The average age at diagnosis was 20.5 ± 9.2 years old. In these patients, excision is the preferred option, with careful determination of the size, depth, and location of the chondral injury for potential future cartilage restoration procedure. Osteochondral lesions / defects (OCD) are a common pathology of subchondral bone and overlying cartilage in children and adolescents. The patient is in the supine position and flexes the knee to 40-45° using knee support (fig. It is used primarily to identify a free body or osteochondral defect (see Pathology section). Normal menisci, collateral ligaments and cruciate ligaments. Osteochondral defects of the lateral femoral condyle are a common sequela after transient lateral patellar dislocation. This condition often is asymptomatic and an incidental finding on knee imaging, but it occasionally may be the cause of knee pain. In this right patellar osteochondral defect, 2 sutures are passed through each of the 2 lateral holes, from the anterior aspect of the patella to the articular side. Women had lower outcomes, and the need for realignment procedures led to a slower recovery. This injury pattern can be explained by the mechanism of injury. A localized osteochondral defect can be created acutely or can develop as an end result of several chronic conditions. Radiology 2002 ;225(3):736–743. Unable to process the form. The most common joint to suffer from an OCD is the knee joint, involving the medial femoral condyle, with the patella being a rare location. There is an articular cartilage defect at the medial patellar facet with adjacent bone marrow edema. To measure the efficacy of osteochondral repair in a primate and determine if osteochondral repair differs in the patella (PA) and the medial femoral condyle (FC) and if passive motion treatment affects osteochondral repair, we created 3.2 mm diameter 4.0 mm deep osteochondral defects of the articular surfaces of the PA and FC in both knees of twelve skeletally mature cynomolgus monkeys. Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management. A chondral defect refers to a focal area of damage to the articular cartilage (the cartilage that lines the end of the bones). MATERIALS AND METHODS: Eight patients (seven male patients, one female patient; age range, 15-42 years; mean age, 27 years) with an OCD in the glenoid fossa were identified. Data on 18 knees in 16 patients who had a minimum followup of 2 years were collected and reviewed (Table 1). Dorsal defect of patella occurs in males and females with equal frequency and is most frequently found in adolescents. A significant number of osteochondral injuries involve the midlateral weight-b earing portion of the lateral fe moral condyle and are more pos- More re-cently, there has been brief mention in both the radiology and orthopedic literature of os-teochondral injuries involving not only the patellar articular surface but also the articular Winn N, Department of Radiology, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, UK. PURPOSE: To evaluate the cross-sectional imaging features of osteochondral defects (OCDs) of the glenoid fossa and to elicit a more detailed analysis of the trauma, if any, that may cause this injury. Clinical presentation. A significant number of osteochondral injuries involve the midlateral weight-bearing portion of the lateral femoral condyle and are more posterior than would be expected after transient dislocation of the patella. Osteochondral Defect Reviewed by Sumer Sethi on Monday, September 15, 2008 Rating: 5. Histologically, it consists of fibrosis with or without bone necrosis. We present the case of a 10-year-old, overweight, female patient. Women had lower outcomes, and the need for realignment procedures led to a slower recovery. The patella is laterally subluxed. cartilage defects are varied and include repair, regeneration, and reconstruction. Purpose: To evaluate functional outcomes and survivorship of the grafts among patients who underwent OCA for patellar cartilage injuries. Femoral trochlea is normal.Â, Normal menisci, collateral ligaments and cruciate ligaments.Â, The patella is a less common site for osteochondritis dissecans (OCD) of the knee. There are kissing-contusions secondary to patella dislocation and a shallow trochlear groove, which has predisposed to patella dislocation during the trauma. An osteochondral defect was identified over the medial facet of patella with a loose osteochondral fragment with very little bone attached to the large cartilaginous part. There is an osteochondral fragment floating within the suprapatellar bursa which is isointense with bone structures in all sequences. Akute osteochondrale Läsionen des Kniegelenks sind Verletzungen, welche häufig im Rahmen von Patellaluxationen auftreten. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Isolated lesions of cartilage or subchondral bone are not considered an OCD 6. Osteochondral injuries represent a spectrum of articular conditions ranging from acute cartilage tears to chronic osteochondral defects, including osteochondritis dissecans (OCD). This unusual fracture was fixed using four biocomposite suture anchors and a bioabsorbable pin. A localized osteochondral defect can be created acutely or can develop as an end result of several chronic conditions. Since June 1982, 26 knees in 24 patients with large osteochondral defects involving the femoral condyles have been treated using the lateral patellar facet as an autograft. 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