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Osteochondritis dissecans des Kniegelenks

Osteochondritis dissecans of the knee joint

  • Knorpeltransplantation
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Zusammenfassung

Hintergrund

Die Osteochondritis dissecans (OD) ist eine Erkrankung des subchondralen Knochens, die mit einer fortschreitenden Ablösung eines osteochondralen Fragments einhergeht.

Methoden

Dieser Beitrag beschreibt die Epidemiologie, Ätiologie, Klinik und Möglichkeiten der radiologischen Diagnostik sowie die Klassifizierung der OD und stellt die konservativen und operativen Therapietechniken dar.

Ergebnisse

Die Behandlung der OD ist von der Größe, Lokalisation, Stabilität des Herdes und Skelettreife abhängig. Die meisten jüngeren Patienten können konservativ behandelt werden. Die chirurgischen Interventionen beinhalten die ante- oder retrograde Anbohrung mit optionaler Refixation und die osteochondrale Transplantation sowie autologe Chondrozytentransplantation.

Schlussfolgerung

Die Ergebnisse der chirurgischen Intervention sind viel versprechend, trotzdem sind weiterführende prospektiv vergleichende Studien zur Beurteilung der Effektivität notwendig.

Abstract

Background

Osteochondritis dissecans (OD) is an affection of the subchondral bone involving progressive detachment of an osteochondral fragment.

Methods

This article describes the epidemiology, etiology, clinical appearance, possibilities for radiological diagnostics, and classification of OD and presents conservative and surgical therapeutic techniques.

Results

Treatment of OD depends on the size, location, stability of the fragment, and skeletal maturity. The majority of young patients can be treated conservatively. Surgical interventions include antegrade or retrograde drilling with optional refixation and osteochondral transplantation as well as autologous chondrocyte transplantation.

Conclusion

The results of surgical intervention are quite promising; nevertheless, further prospective comparative studies are necessary to evaluate effectivity.

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Literatur

  1. Aglietti P, Buzzi R, Bassi PB, Fioriti M (1994) Arthroscopic drilling in juvenile osteochondritis dissecans of the medial femoral condyle. Arthroscopy 10:286–291

    CAS  PubMed  Google Scholar 

  2. Barrie HJ (1987) Osteochondritis dissecans 1887–1987. A centennial look at Konig’s memorable phrase. J Bone Joint Surg [Br] 69:693–695

    Google Scholar 

  3. Berndt AL, Harty M (1959) Transchondral fractures (osteochondritis dissecans) of the talus. J Bone Joint Surg [Am] 41:988–1020

    Google Scholar 

  4. Bohndorf K (1998) Osteochondritis (osteochondrosis) dissecans: a review and new MRI classification. Eur Radiol 8:103–112

    Article  CAS  PubMed  Google Scholar 

  5. Bradley J, Dandy DJ (1989) Results of drilling osteochondritis dissecans before skeletal maturity. J Bone Joint Surg [Br] 71:642–644

    Google Scholar 

  6. Bruns J (1997) Osteochondrosis dissecans. Orthopäde 26:573–584

  7. Cain EL, Clancy WG (2001) Treatment algorithm for osteochondral injuries of the knee. Clin Sports Med 20:321–342

    CAS  PubMed  Google Scholar 

  8. De Smet AA, Ilahi OA, Graf BK (1997) Untreated osteochondritis dissecans of the femoral condyles: prediction of patient outcome using radiographic and MR findings. Skeletal Radiol 26:463–467

    Article  PubMed  Google Scholar 

  9. Dipaola JD, Nelson DW, Colville MR (1991) Characterizing osteochondral lesions by magnetic resonance imaging. Arthroscopy 7:101–104

    Article  CAS  PubMed  Google Scholar 

  10. Ewing JW, Voto SJ (1988) Arthroscopic surgical management of osteochondritis dissecans of the knee. Arthroscopy 4:37–40

    CAS  PubMed  Google Scholar 

  11. Guhl JF (1982) Arthroscopic treatment of osteochondritis dissecans. Clin Orthop 167:65–74

    PubMed  Google Scholar 

  12. Harding WG (1977) Diagnosis of ostechondritis dissecans of the femoral condyles: the value of the lateral x-ray view. Clin Orthop 123:25–26

    PubMed  Google Scholar 

  13. Hefti F, Beguiristain J, Krauspe R et al. (1999) Osteochondritis dissecans: a multicenter study of the European Pediatric Orthopedic Society. J Pediatr Orthop B 8:231–245

    CAS  PubMed  Google Scholar 

  14. Hughston JC, Hergenroeder PT, Courtenay BG (1984) Osteochondritis dissecans of the femoral condyles. J Bone Joint Surg [Am] 66:1340–1348

    Google Scholar 

  15. Kocher MS, DiCanzio J, Zurakowski D, Micheli LJ (2001) Diagnostic performance of clinical examination and selective magnetic resonance imaging in the evaluation of intraarticular knee disorders in children and adolescents. Am J Sports Med 29:292–296

    CAS  PubMed  Google Scholar 

  16. Kocher MS, Micheli LJ, Yaniv M, Zurakowski D, Ames A, Adrignolo AA (2001) Functional and radiographic outcome of juvenile osteochondritis dissecans of the knee treated with transarticular arthroscopic drilling. Am J Sports Med 29:562–566

    CAS  PubMed  Google Scholar 

  17. Marlovits S, Singer P, Resinger C, Aldrian S, Kutscha-Lissberg F, Vécsei V (2004) Ostochondritis dissecans of the knee. Eur Surg 36:25–32

    Article  Google Scholar 

  18. Mesgarzadeh M, Sapega AA, Bonakdarpour A et al. (1987) Osteochondritis dissecans: analysis of mechanical stability with radiography, scintigraphy, and MR imaging. Radiology 165:775–780

    CAS  PubMed  Google Scholar 

  19. Mizuta H, Nakamura E, Otsuka Y, Kudo S, Takagi K (2001) Osteochondritis dissecans of the lateral femoral condyle following total resection of the discoid lateral meniscus. Arthroscopy 17:608–612

    CAS  PubMed  Google Scholar 

  20. Mubarak SJ, Carroll NC (1979) Familial osteochondritis dissecans of the knee. Clin Orthop 140:131–136

    PubMed  Google Scholar 

  21. Mubarak SJ, Carroll NC (1981) Juvenile osteochondritis dissecans of the knee: etiology. Clin Orthop 157:200–211

    PubMed  Google Scholar 

  22. Pappas AM (1981) Osteochondrosis dissecans. Clin Orthop 158:59–69

    PubMed  Google Scholar 

  23. Peterson L, Minas T, Brittberg M, Lindahl A (2003) Treatment of osteochondritis dissecans of the knee with autologous chondrocyte transplantation: results at two to ten years. J Bone Joint Surg [Am] 85-A [suppl 2]:17–24

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

    Article  PubMed  Google Scholar 

  25. Sales de Gauzy J, Mansat C, Darodes PH, Cahuzac JP (1999) Natural course of osteochondritis dissecans in children. J Pediatr Orthop B 8:26–28

    PubMed  Google Scholar 

  26. Schenck RC Jr, Goodnight JM (1996) Osteochondritis dissecans. J Bone Joint Surg [Am] 78:439–456

    Google Scholar 

  27. Twyman RS, Desai K, Aichroth PM (1991) Osteochondritis dissecans of the knee. A long-term study. J Bone Joint Surg [Br] 73:461–464

    Google Scholar 

  28. Williams JS jr, Bush-Joseph CA, Bach BR jr (1998) Osteochondritis dissecans of the knee. Am J Knee Surg 11:221–232

    PubMed  Google Scholar 

  29. Wilson JN (1967) A diagnostic sign in osteochondritis dissecans of the knee. J Bone Joint Surg [Am] 49:477–480

    Google Scholar 

  30. Yoshida S, Ikata T, Takai H, Kashiwaguchi S, Katoh S, Takeda Y (1998) Osteochondritis dissecans of the femoral condyle in the growth stage. Clin Orthop 346:162–170

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Universitätsklinik für Unfallchirurgie, Medizinische Universität Wien

    F. Kutscha-Lissberg, P. Singer, V. Vécsei & S. Marlovits

  2. Ludwig-Boltzmann-Institut für Biomechanik und Zellbiologie, Wien

    V. Vécsei & S. Marlovits

  3. Universitätsklinik für Unfallchirurgie, Medizinische Universität Wien, Währinger Gürtel 18–20, 1090, Wien, Österreich

    F. Kutscha-Lissberg

Authors
  1. F. Kutscha-Lissberg
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  2. P. Singer
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  3. V. Vécsei
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  4. S. Marlovits
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Correspondence to F. Kutscha-Lissberg.

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Kutscha-Lissberg, F., Singer, P., Vécsei, V. et al. Osteochondritis dissecans des Kniegelenks. Radiologe 44, 783–788 (2004). https://doi.org/10.1007/s00117-004-1086-9

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  • DOI: https://doi.org/10.1007/s00117-004-1086-9

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