Skip to main content
SpringerLink
Log in

Osteochondritis Dissecans of the Knee in Football Players

  • Chapter
  • First Online:
Injuries and Health Problems in Football

Abstract

Osteochondritis dissecans (OCD) of the knee is a frequent cause of pain and functional limitation among skeletally immature and young athletes. Chronic overuse of the lower extremity in young soccer players can cause OCD at the knee and ankle joints; furthermore, with increased competitiveness of amateur sports, more injuries may cause OCD. Increased joint stress, such as an increased pressure at the medial femoral condyle in young patients with genu varum, might cause decreased blood flow and trigger the development of OCD. Symptoms are usually preceded by trauma in 40–60% of the cases. Juveniles and adolescents will complain of vague, nonspecific poorly localized anterior knee pain with variable intermittent amount of swelling, locking of the knee grinding, or catching; pain is aggravated by activity and relieved by rest. If not recognized and appropriately treated, it can create further limitation and lead to early osteoarthritis. OCD is a disorder of one or more ossification centers, characterized by sequential degeneration or aseptic necrosis and recalcification. OCD lesions involve both bone and cartilage but appear to affect the subchondral bone primarily and secondarily affect the articular cartilage.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Aglietti P, Buzzi R, Bassi FB, Fioriti M. Arthroscopic drilling in juvenile osteochondritis dissecans of the medial femoral condyle. Arthroscopy. 1994;10:286–91.

    Article  CAS  PubMed  Google Scholar 

  2. Aglietti P, Ciardullo A, Giron F. Results of arthroscopic excision of the fragments in the treatment of osteochondritis dissecans of the knee. Arthroscopy. 2001;17:741–6.

    Article  CAS  PubMed  Google Scholar 

  3. Anderson AF, Pagnani M. Osteochondritis dissecans of the femoral condyles: long term results of excision of the fragment. Am J Sports Med. 1997;25:830–4.

    Article  CAS  PubMed  Google Scholar 

  4. Anderson AF, Richards D, Pagani MJ, Hovis WD. Antegrade drilling for osteochondritis dissecans of the knee. Arthroscopy. 1997;13:319–24.

    Article  CAS  PubMed  Google Scholar 

  5. Bates JT, Jacobs Jr JC, Shea KG. Emerging genetic basis of osteochondritis dissecans. Clin Sports Med. 2014;33(2):199–220.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Bradford G, Svendsen R. Synovitis of the knee after intraarticular fixation with Biofix: report of two cases. Acta Orthop Scand. 1992;63:680–1.

    Google Scholar 

  7. Cahill BR. Osteochondritis dissecans of the knee: treatment of juvenile and adult forms. J Am Acad Orthop Surg. 1995;3:237–47.

    Article  CAS  PubMed  Google Scholar 

  8. Cain EL, Clancy W. Treatment algorithm for osteochondral injuries of the knee. Clin Sports Med. 2001;20:321–42.

    Article  CAS  PubMed  Google Scholar 

  9. Caffey J, Madell S, Royer C, Morales P. Ossification of the distal femoral epiphysis. J Bone Joint Surg Am. 1958;40:647–54.

    Article  PubMed  Google Scholar 

  10. Campbell CJ, Ranawat C. Osteochondritis dissecans: the question of etiology. J Trauma. 1966;6:201–21.

    Article  CAS  PubMed  Google Scholar 

  11. Chiroff RT, Cooke C. Osteochondritis dissecans: a histologic and microradioographic analysis of surgical excised lesions. J Trauma. 1975;15:689–96.

    Article  CAS  PubMed  Google Scholar 

  12. Fairbank HA. Osteochondritis dissecans. British J Surg. 1933;21:67–82.

    Article  Google Scholar 

  13. Filardo G, Kon E, Di Martino A, Busacca M, Altadonna G, Marcacci M. Treatment of knee osteochondritis dissecans with a cell-free biomimetic osteochondral scaffold clinical and imaging evaluation at 2-year follow-up. Am J Sports Med. 2013;41(8):1786–93.

    Article  PubMed  Google Scholar 

  14. Fisher AG. A study of loose bodies composed of cartilage and bone occurring in joints. With special reference to their aethiology and pathology. British J Surg. 1921;8:493–523.

    Article  Google Scholar 

  15. Frederico DJ, Lynch J, Jokl P. Osteochondritis dissecans of the knee: a historical review of etiology and treatment. Arthroscopy. 1990;6:190–7.

    Article  Google Scholar 

  16. Freidrichs MG, Greis P, Burks RT. Pitfalls associated with fixation of osteochondritis dissecans fragments using bioabsorbable screws. Arthroscopy. 2001;17:542–5.

    Article  Google Scholar 

  17. Gardiner TB. Osteochondritis dissecans in three members of one family. J Bone Joint Surg Br. 1955;37:139–41.

    PubMed  Google Scholar 

  18. Garrett JC. Osteochondritis dissecans. Clin Sports Med. 1991;10:569–93.

    CAS  PubMed  Google Scholar 

  19. Garrett JC, Kress K, Mudano M. Osteochondritis dissecans of the lateral femoral condyle in the adult. Arthroscopy. 1992;8:474–81.

    Article  CAS  PubMed  Google Scholar 

  20. Gobbi A, Chaurasia S, Karnatzikos G, Nakamura N. Matrix-induced autologous chondrocyte implantation versus multipotent stem cells for the treatment of large patellofemoral chondral lesions: a nonrandomized prospective trial. Carcinogenesis. 2015;6(2):82–97.

    CAS  Google Scholar 

  21. Gobbi A, Scotti C, Karnatzikos G, Mudhigere A, Castro M, Peretti GM. One-step surgery with multipotent stem cells and Hyaluronan-based scaffold for the treatment of full-thickness chondral defects of the knee in patients older than 45 years. Knee Surg Sports Traumatol Arthrosc. 2016;14:1–8.

    Google Scholar 

  22. Gobbi A, Whyte GP. One-stage cartilage repair using a hyaluronic acid-based scaffold with activated bone marrow-derived mesenchymal stem cells compared with microfracture: five-year follow-up. Am J Sports Med. 2016;44:2846–54.

    Article  PubMed  Google Scholar 

  23. Green WT, Banks H. Osteochondritis dissecans in children. J Bone Joint Surg Am. 1953;35:26–47.

    Article  PubMed  Google Scholar 

  24. Guhl JF. Arthroscopic treatment of osteochondritis dissecans. Clin Orthop Relat Res. 1982;167:65–74.

    Google Scholar 

  25. Guzzo RM, Gibson J, Xu RH, Lee FY, Drissi H. Efficient differentiation of human iPSC‐derived mesenchymal stem cells to chondroprogenitor cells. J Cell Biochem. 2013;114(2):480–90.

    Article  CAS  PubMed  Google Scholar 

  26. Hayashi D, Guermazi A, Kwoh CK, et al. Semiquantitative assessment of subchondral bone marrow edema-like lesions and subchondral cysts of the knee at 3T MRI: a comparison between intermediate-weighted fat-suppressed spin echo and Dual Echo Steady State sequences. BMC Musculoskelet Disord. 2011;12:198.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Hefti F, Beguiristain J, Krauspe R, et al. Osteochondritis dissecans: a multicenter study of the European Pediatric Orthopedic Society. J Pediatr Orthop B. 1999;8:231–45.

    CAS  PubMed  Google Scholar 

  28. Johnson LL, De Lano MC, Spector M. The biological response following autogenous bone grafting for large-volume defects of the knee: index surgery through 12 to 21 Years’ follow up. Carcinogenesis. 2012;3(1):86–99.

    Google Scholar 

  29. Kocher MS, Micheli L, Yaniv M, et al. Functional and radiographic outcomes of juvenile osteochondritis dissecans of the knee treated with transarticular drilling. Am J Sports Med. 2001;29:562–6.

    Article  CAS  PubMed  Google Scholar 

  30. Konig F. Ueber freie Körper in den Gelenken. Deutsche Zeitschr Chir. 1888;27:90–109.

    Article  Google Scholar 

  31. Linden B. The incidence of osteochondritis dissecans in the condyles of the femur. Acta Orthop Scand. 1976;47:666–7.

    Google Scholar 

  32. Mubarak SJ, Carroll NC. Familial osteochondritis of the knee. Clin Orthop. 1979;140:131–6.

    Google Scholar 

  33. Peterson L, Minas T, Brittberg M, Lindhal A. Treatment of osteochondritis dissecans of the knee with autologous chondrocyte transplantation: results at two to ten years. J Bone Joint Surg Am. 2003;85:17–24.

    Article  PubMed  Google Scholar 

  34. Ribbing S. The hereditary multiple epiphyseal disturbance and its consequences for the aetiogenesis of local malacias-particularly the osteochondritis dissecans. Acta Orthop Scand. 1955;24:286–99.

    Article  CAS  PubMed  Google Scholar 

  35. Robertson W, Kelly BT, Green DW. Osteochondritis dissecans of the knee in children. Curr Opin Pediatr. 2003;15:38–44.

    Article  PubMed  Google Scholar 

  36. Rogers WM, Gladstone H. Vascular foramina and arterial supply of the distal end of the femur. J Bone Joint Surg Am. 1950;32:867–74.

    Article  PubMed  Google Scholar 

  37. Sadlik B, Gobbi A, Puszkarz M, Klon W, Whyte GP. Biologic inlay osteochondral reconstruction: arthroscopic one-step osteochondral lesion repair in the knee using morselized bone grafting and hyaluronic acid-based scaffold embedded with bone marrow aspirate concentrate. Arthrosc Tech. In press 2016. doi: 10.1016/j.eats.2016.10.023.

  38. Schenck Jr RC, Goodnight JM. Osteochondritis dissecans. J Bone Joint Surg Am. 1996;78:439–78.

    Article  PubMed  Google Scholar 

  39. Schwarz C, Blazina ME, Sisto DJ, Hirsh LC. The results of operative treatment of osteochondritis dissecans of the patella. Am J Sports Med. 1988;16:522–9.

    Article  CAS  PubMed  Google Scholar 

  40. Smet AA, Ilahi OA, Graf BK. Untreated osteochondritis dissecans of the femoral condyles: prediction of patient outcome using radiographic and MR findings. Skelet Radiol. 1997;26(8):463–7.

    Article  Google Scholar 

  41. Smillie IS. Treatment of osteochondritis dissecans. J Bone Joint Surg Br. 1957;29:248–60.

    Google Scholar 

  42. Stougart J. Familial occurrence of osteochondritis dissecans. J Bone Joint Surg Br. 1964;46:542–3.

    Article  Google Scholar 

  43. Stougart J. The hereditary factor in osteochondritis dissecans. J Bone Joint Surg Br. 1961;43:256–8.

    Google Scholar 

  44. Sudo K, Kanno M, Miharada K, Ogawa S, Hiroyama T, Saijo K, Nakamura Y. Mesenchymal progenitors able to differentiate into osteogenic, chondrogenic, and/or adipogenic cells in vitro are present in most primary fibroblast‐like cell populations. Stem Cells. 2007;25(7):1610–7.

    Article  CAS  PubMed  Google Scholar 

  45. Twyman RS, Desai K, Aichroth PM. Osteochondritis dissecans of the knee: a long term study. J Bone Joint Surg Br. 1991;73:461–4.

    Article  CAS  PubMed  Google Scholar 

  46. Wall EJ, Polousky JD, Shea KG, Carey JL, Ganley TJ, Grimm NL, Jacobs JC, Edmonds EW, Eismann EA, Anderson AF, Heyworth BE, Lyon R, Murnaghan ML, Nissen C, Weiss J, Wright R, Myer GD. Novel radiographic feature classification of knee osteochondritis dissecans: a multicenter reliability study. Am J Sports Med. 2015;43:303–9.

    Article  PubMed  Google Scholar 

  47. Wall E, Von Stein D. Juvenile osteochondritis dissecans. Orthop Clin North Am. 2003;34(3):341–53.

    Article  PubMed  Google Scholar 

  48. Whyte GP, Gobbi A, Sadlik B. Dry arthroscopic single-stage cartilage repair of the knee using a hyaluronic acid-based scaffold with activated bone marrow-derived mesenchymal stem cells. Arthrosc Tech. 2016;5:e913–8.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Wilson JN. A diagnostic sign in osteochondritis dissecans of the knee. J Bone Joint Surg Am. 1967;49-A:477–80.

    Article  Google Scholar 

  50. Wright RW, McLean M, Matava MJ. Osteochondritis dissecans of the knee: long term results of excision of the fragment. Clin Orthop Relat Res. 2004;424:239–43.

    Article  Google Scholar 

  51. Wu JZ, Herzog W, Hasler EM. Inadequate placement of osteochondral plugs may induce abnormal stress strain distributions in articular cartilage – finite element stimulations. Med Eng Phys. 2002;24:85–97.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. OASI Bioresearch Foundation Gobbi NPO, Milan, Italy

    Alberto Gobbi

  2. Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal

    João Espregueira-Mendes

  3. Dom Henrique Research Centre, Porto, Portugal

    João Espregueira-Mendes

  4. 3B’s Research Group – Biomaterials, Biodegradables and Biomimetics, University Minho, AvePark, S. Cláudio de Barco, 4806-909, Taipas, Guimarães, Portugal

    João Espregueira-Mendes

  5. ICVS/3B’s – PT Government Associated Laboratory, Braga, Portugal

    João Espregueira-Mendes

  6. Orthopedic Department, Minho University, Braga, Portugal

    João Espregueira-Mendes

  7. Department of Orthopedics, Acibadem University, Istanbul, Turkey

    Mustafa Karahan

  8. Traumatology and Sports Medicine Department of the Federal, University of São Paulo, São Paulo, Brazil

    Moisés Cohen

  9. Department of Orthopaedics and Rehabilitation, New York Presbyterian Hospital/Queens, New York, NY, USA

    Graeme P. Whyte

Authors
  1. Alberto Gobbi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. João Espregueira-Mendes
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mustafa Karahan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Moisés Cohen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Graeme P. Whyte
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alberto Gobbi .

Editor information

Editors and Affiliations

  1. Department of Orthopaedic Surgery, Academic Medical Centre, Amsterdam Zuidoost, Noord-Holland, The Netherlands

    C. Niek van Dijk

  2. Hopital de la Croix-Rousse, University of Lyon 1 Hopital de la, Croix-Rousse, Lyon, France

    Philippe Neyret

  3. Department of Orthopedics & Traumatology, Federal University of São Paulo, Vila Clementino - São Paulo, Brazil

    Moises Cohen

  4. Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy

    Stefano Della Villa

  5. 3B’s Research Group–Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, Guimarães, Portugal

    Helder Pereira

  6. ICVS/3B’s–PT Government Associate Laboratory, Braga/Guimarães, Portugal

    J. Miguel Oliveira

Rights and permissions

Reprints and permissions

Copyright information

© 2017 ISAKOS

About this chapter

Cite this chapter

Gobbi, A., Espregueira-Mendes, J., Karahan, M., Cohen, M., Whyte, G.P. (2017). Osteochondritis Dissecans of the Knee in Football Players. In: van Dijk, C., Neyret, P., Cohen, M., Della Villa, S., Pereira, H., Oliveira, J. (eds) Injuries and Health Problems in Football . Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-53924-8_17

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-53924-8_17

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-53923-1

  • Online ISBN: 978-3-662-53924-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation