Osteochondritis dissecans is a localized injury or condition affecting an articular surface that involves separation of a segment of cartilage and subchondral bone. It is found primarily in the ankle, knee, and elbow joints. Although relatively infrequent, osteochondritis dissecans has been reported extensively in the orthopaedic literature. Various theories about its etiology have been proposed, but none has been accepted universally or has adequately explained its occurrence; however, the lesion is probably caused by factors that vary depending on the specific joint involved and on the specific site within that joint. The treatment of osteochondritis dissecans has evolved from the removal of loose bodies, first reported more than 150 years ago108, to the resurfacing of defects with an osteochondral autogenous graft158. The results of current treatment are still not uniformly successful.
Osteochondritis dissecans has been confused with other abnormalities of the joint surface, and therefore the orthopaedic literature must be read with care. Other, severe conditions described in the literature have been grouped under the heading of osteochondritis dissecans; these have included osteochondral fractures104,110,116,123,133, osteonecrosis, accessory centers of ossification, osteochondrosis, and hereditary epiphyseal dysplasia22,118,119,147. In several clinical investigations, different terms, such as osteochondrosis dissecans107 and osteochondral fragments51,70,81,83,122, have been used to describe this entity. The recognition that many disorders may result in an osteochondritis dissecans-like lesion is fundamental to an understanding of this condition.
The orthopaedic literature includes descriptions of lesions of osteochondritis dissecans in the talus5,12,28, the capitellum19,96,156, the patella43,127,138, the femoral head107, the distal part …
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