MRI of Osteochondral Defects of the Lateral Femoral Condyle: Incidence and Pattern of Injury After Transient Lateral Dislocation of the Patella. Osteochondral allograft (cadaveric donor) When the latter is present, then joint replacement is often the only feasible treatment.Īt earlier stages (stage 1 to 4), a number of options exist including: Treatment depends on the location and size of the defect as well as the presence of secondary degenerative changes. Low signal loose bodies, outlined by high signal fluidĭonor defect filled with high signal fluid High signal line ( rim sign) demarcating fragment from bone usually indicates an unstable lesion, however, false positives can result from oedema The signal is variable with intermediate to low signal adjacent to fragment and variable fragment signal This is essential in determining management. MRI is the modality of choice, with high sensitivity and specificity for the detection of separation of the osteochondral fragment (see: osteochondral injury staging and osteochondritis dissecans surgical staging). However, they are insensitive to grading lower stage lesions and are inadequate in predicting stability. Radiographic features Plain radiograph and CTīoth x-rays and CT are able to detect displaced defects with ease. Osteochondral injuries are graded according to the stability and location of the fragment and presence of secondary degenerative changes (see: osteochondral injury staging). The recognised sites of osteochondral defects are:įemoral condyle (most common in the lateral aspect of the medial femoral condyle) following anterior cruciate ligament repair) Osteochondritis dissecans: thought to be due to repeated microtraumaĪrticular collapse secondary to osteonecrosis or subchondral insufficiency fracture Please note that OCD is a commonly used abbreviation for both osteochondral defect and osteochondritis dissecans, two closely related conditions. Isolated lesions of cartilage or subchondral bone are not considered an OCD 6. It is often used synonymously with osteochondral injury/defect and in the paediatric population. Osteochondral defect is a broad term that describes the morphological changes associated to a localised gap in the articular cartilage and subchondral bone 5.
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