Abstract
Osteochondral injuries in pediatric patients may occur as a result of a traumatic
injury or secondary to an osteochondritis dissecans (OCD) lesion. Lateral patella
dislocation is a common traumatic cause of osteochondral injury that typically occurs
at the medial facet of the patella or at the lateral aspect of the distal femur. Multiple
theories have been proposed for the cause of an OCD lesion in the knee, including
trauma or repetitive microtrauma, local vascular insufficiency, and family history.
The most “classic” location for OCD lesions of the knee is the lateral aspect of the
medial femoral condyle of the distal femur. Multiple treatment options are available
for both traumatic osteochondral injuries and OCD lesions, with important determining
factors of treatment being skeletal maturity of the patient, instability of the fragment,
lesion location, and size of the lesion. Nonsurgical management is appropriate in
some situations. Surgical options range from simple fragment excision to internal
fixation of the fracture fragment to more complex cartilage restoration or replacement
procedures. This special focus section will discuss the diagnosis and treatment options
for traumatic osteochondral knee injuries, including the subset secondary to juvenile
OCD lesions.
Keywords
osteochondral injury - articular cartilage - osteochondritis dissecans - osteochondral
allograft - patellar dislocation
