Predictive factors for osteochondritis dissecans of the lateral femoral condyle concurrent with a discoid lateral meniscus

  • Junsei Takigami
  • Yusuke Hashimoto
  • Tomohiro Tomihara
  • Shinya Yamasaki
  • Koji Tamai
  • Kyoko Kondo
  • Hiroaki Nakamura



Osteochondritis dissecans (OCD) of the lateral femoral condyle is relatively rare, and it is often reported in combination with discoid lateral meniscus. However, little is known about the mechanism underlying this connection. Predictive factors for OCD coinciding with discoid lateral meniscus in Japanese children and adolescents were assessed.


During 2000–2015, 152 knees in 133 patients aged 5–15 years were diagnosed with symptomatic complete discoid lateral meniscus. Patients were evaluated using radiography and magnetic resonance imaging (MRI). OCD was radiographically graded using the Brückl classification. Based on Ahn’s MRI classifications, discoid lateral meniscus was divided into four types of meniscal shift: no shift (N), anterocentral (AC), posterocentral (PC), or central (C). Relationships between OCD and patient sex, age and Ahn’s shift type were analysed.


OCD of the lateral femoral condyle was associated with discoid lateral meniscus in 22 (14.5%) of 152 knees. OCD was classified as Brückl’s stage 1 in 5 knees, stage 2 in 12, stage 3 in 3, stage 4 in 1, and stage 5 in 1. OCD was found in 12 of 96 knees (12.5%) with type N meniscal shift, 4 of 24 knees (16.7%) with type AC, 0 of 21 knees (0%) with type PC, and 6 of 11 knees (54.5%) with type C. Multivariate logistic regression analysis showed that males had a significantly increased odds ratio (OR) [14.8; 95% confidence interval (CI) 2.6–83.4]. Those aged 5–11 years had a significantly higher OR (12.5; 95% CI 2.8–55.9) than those aged 12–15 years. The OR for type C coinciding with OCD was significantly elevated (13.4; 95% CI 2.3–78.7).


Concurrent OCD was found in 22 (14.5%) of 152 knees with discoid lateral meniscus. Male sex, young age (5–11 years), and having a type C meniscal shift of the discoid lateral meniscus as shown by MRI were found to be predictive factors for OCD of the LFC.

Level of evidence



Osteochondritis dissecans (OCD) Discoid lateral meniscus Brückl classification Ahn classification Radiography Magnetic resonance imaging (MRI) 


Compliance with ethical standards

Funding sources

This study was funded by a grant from the Japanese Foundation for Research and Promotion of Endoscopy.

Conflict of interest

The authors declare no conflict of interest associated with this manuscript.

Ethical approval

This study was approved by the internal review board of Osaka City University School of Medicine (approval number 2727).

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Ahn JH, Lee YS, Ha HC, Shim JS, Lim KS (2009) A novel magnetic resonance imaging classification of discoid lateral meniscus based on peripheral attachment. Am J Sports Med 37:1564–1569CrossRefPubMedGoogle Scholar
  2. 2.
    Aichroth P (1971) Osteochondritis dissecans of the knee. A clinical survey. J Bone Joint Surg Br 53:440–447CrossRefPubMedGoogle Scholar
  3. 3.
    Aichroth PM, Patel DV, Marx CL (1991) Congenital discoid lateral meniscus in children. J Bone Joint Surg Br 73:932–936CrossRefPubMedGoogle Scholar
  4. 4.
    Atay OA, Doral MN, Leblebicioğlu G, Tetik O, Aydingöz U (2003) Management of discoid lateral meniscus tears: observations in 34 knees. Arthroscopy 19:346–352CrossRefPubMedGoogle Scholar
  5. 5.
    Atay OA, Pekmezci M, Doral MN, Sargon MF, Ayvaz M, Johnson DL (2007) Discoid meniscus: an ultrastructural study with transmission electron microscopy. Am J Sports Med 35:475–478CrossRefPubMedGoogle Scholar
  6. 6.
    Brückl R, Rosemeyer B, Thiermann G (1982) Results of operative treatment of osteochondrosis dissecans of the knee joint in juveniles. Z Orthop Ihre Grenzgeb 120:717–724CrossRefPubMedGoogle Scholar
  7. 7.
    Camathias C, Hirschmann MT, Vavken P (2014) Meniscal suturing versus screw fixation for treatment of osteochondritis dissecans: clinical and magnetic resonance imaging results. Arthroscopy 30:1269–1279CrossRefPubMedGoogle Scholar
  8. 8.
    Chatain F, Adeleine P, Chambat P, Neyret P; Société Française d’Arthroscopie (2003) A comparative study of medial versus lateral arthroscopic partial meniscectomy on stable knees: 10-year minimum follow-up. Arthroscopy 19:842–849CrossRefPubMedGoogle Scholar
  9. 9.
    Choi SH, Ahn JH, Kim KI et al (2015) Do the radiographic findings of symptomatic discoid lateral meniscus in children differ from normal control subjects? Knee Surg Sports Traumatol Arthrosc 23:1128–1134CrossRefPubMedGoogle Scholar
  10. 10.
    Christoforakis J, Pradhan R, Sanchez-Ballester J, Hunt N, Strachan RK (2005) Is there an association between articular cartilage changes and degenerative meniscus tears? Arthroscopy 21:1366–1369CrossRefGoogle Scholar
  11. 11.
    Cui JH, Min BH (2007) Collagenous fibril texture of the discoid lateral meniscus. Arthroscopy 23:635–641CrossRefPubMedGoogle Scholar
  12. 12.
    Deie M, Ochi M, Sumen Y, Kawasaki K, Adachi N, Yasunaga Y, Ishida O (2006) Relationship between osteochondritis dissecans of the lateral femoral condyle and lateral menisci types. J Pediatr Orthop 26:79–82CrossRefPubMedGoogle Scholar
  13. 13.
    Fu D, Guo L, Yang L (2014) Discoid lateral meniscus tears and concomitant articular cartilage lesions in the knee. Arthroscopy 30:311–318CrossRefPubMedGoogle Scholar
  14. 14.
    Good CR, Green DW, Griffith MH, Valen AW, Widmann RF, Rodeo SA (2007) Arthroscopic treatment of symptomatic discoid meniscus in children: classification, technique, and results. Arthroscopy 23:157–163CrossRefPubMedGoogle Scholar
  15. 15.
    Hamada M, Shino K, Kawano K, Araki Y, Matsui Y, Doi T (1994) Usefulness of magnetic resonance imaging for detecting intrasubstance tear and/or degeneration of lateral discoid meniscus. Arthroscopy 10:645–653CrossRefPubMedGoogle Scholar
  16. 16.
    Hidaka S, Sugioka Y, Kameyama H. (1983) Pathogenesis and treatment of osteochondritis dissecans—an experimental study on chondral and osteochondral fractures in adult and young rabbits. Nihon Seikeigeka Gakkai Zasshi 57:329–339.PubMedGoogle Scholar
  17. 17.
    Irani RN, Karasick D, Karasick S (1984) A possible explanation of the pathogenesis of osteochondritis dissecans. J Pediatr Surg 4:358–360Google Scholar
  18. 18.
    Kessler J, Koebnick C, Smith N, Adams A (2013) Childhood obesity is associated with increased risk of most lower extremity fractures. Clin Orthop Relat Res 471:1199–1207CrossRefPubMedGoogle Scholar
  19. 19.
    Kessler JI, Nikizad H, Shea KG, Jacobs JC Jr, Bebchuk JD, Weiss JM (2014) The demographics and epidemiology of osteochondritis dissecans of the knee in children and adolescents. Am J Sports Med 42:320–326CrossRefPubMedGoogle Scholar
  20. 20.
    Kim SJ, Lee YT, Kim DW (1998) Intraarticular anatomic variants associated with discoid meniscus in Koreans. Clin Orthop Relat Res 356:202–207CrossRefGoogle Scholar
  21. 21.
    Kurz B, Lemke AK, Fay J, Pufe T, Grodzinsky AJ, Schünke M (2005) Pathomechanisms of cartilage destruction by mechanical injury. Ann Anat 187:473–485CrossRefGoogle Scholar
  22. 22.
    Lim HC, Bae JH (2011) Meniscoplasty for stable osteochondritis dissecans of the lateral femoral condyle combined with a discoid lateral meniscus: a case report. J Med Case Rep 5:434CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Mitsuoka T, Shino K, Hamada M, Horibe S (1999) Osteochondritis dissecans of the lateral femoral condyle of the knee joint. Arthroscopy 15:20–26CrossRefPubMedGoogle Scholar
  24. 24.
    Okazaki K, Miura H, Matsuda S, Hashizume M, Iwamoto Y (2006) Arthroscopic resection of the discoid lateral meniscus: long-term follow-up for 16 years. Arthroscopy 22:967–971CrossRefPubMedGoogle Scholar
  25. 25.
    Papadopoulos A, Kirkos JM, Kapetanos GA (2009) Histomorphologic study of discoid meniscus. Arthroscopy 25:262–268CrossRefPubMedGoogle Scholar
  26. 26.
    Räber DA, Friederich NF, Hefti F (1998) Discoid lateral meniscus in children. Long-term follow-up after total meniscectomy. J Bone Joint Surg Am 80:1579–1586CrossRefPubMedGoogle Scholar
  27. 27.
    Samora WP, Chevillet J, Adler B, Young GS, Klingele KE (2012) Juvenile osteochondritis dissecans of the knee: predictors of lesion stability. J Pediatr Orthop 32:1–4CrossRefPubMedGoogle Scholar
  28. 28.
    Schenck RC Jr, Goodnight JM (1996) Osteochondritis dissecans. J Bone Joint Surg Am 78:439–456CrossRefPubMedGoogle Scholar
  29. 29.
    Tomatsu T, Imai N, Takeuchi N et al (1992) Experimentally produced fractures of articular cartilage and bone. The effects of shear forces on the pig knee. J Bone Joint Surg Br 74:457–462CrossRefPubMedGoogle Scholar
  30. 30.
    Watanabe M, Takeda S, Ikeuchi H (1978) Atlas of arthroscopy. Igaku-Shoin, Tokyo:1–156Google Scholar

Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2017

Authors and Affiliations

  • Junsei Takigami
    • 1
  • Yusuke Hashimoto
    • 2
  • Tomohiro Tomihara
    • 1
  • Shinya Yamasaki
    • 4
  • Koji Tamai
    • 2
  • Kyoko Kondo
    • 3
  • Hiroaki Nakamura
    • 2
  1. 1.Department of Orthopaedic SurgeryShimada HospitalHabikinoJapan
  2. 2.Department of Orthopaedic SurgeryOsaka City University Graduate School of MedicineOsakaJapan
  3. 3.Department of Public HealthOsaka City University Faculty of MedicineOsakaJapan
  4. 4.Department of Orthopaedic SurgeryOsaka City General HospitalOsakaJapan

Personalised recommendations