• Clinics in Shoulder and Elbow
• /
• v.3 no.2
• /
• pp.115-117
• /
• 2000

Adult type of osteochondritis dissecans of elbow is very rare condition. We describe a case of a osteochondritis dissecans of capitellum in 51-year-old male patient. We performed arthroscopy procedure for removal of loose osteochondral fragments. After I year follow-up, the patient gained good result.

• Journal of the Korean Arthroscopy Society
• /
• v.9 no.2
• /
• pp.206-213
• /
• 2005

Purpose: To evaluate the outcome of symptomatic osteochondritis dissecans of the talus treated with arthroscopic debridement and multiple drilling. Materials and Methods: Between 1997 and 2003, 14 arthroscopic debridement(group I) and 15 arthroscopic multiple drilling(group II) were performed. There are 21 male and 8 female patients. Mean age was 34.4 years(33.8 years in group I, 37.5 years in group II) and average follow-up period was 43.2 months(46.4 months in group I, 40.1 months in group II). Simple radiographs and MRI were performed preoperatively and postoperatively, and the progressive stage of the lesions was evaluated through the arthroscopic surgery. Clinical results were evaluated with ankle-hindfoot scale and scoring scale for subjective and objective functional outcomes. The results were compared between 2 groups. Results: There are 20 medial(7 in group I, 13 in group II), 6 lateral(5 in group I, 1 in group II), and 3 both-side(2 in group I, 1 in group II) lesions. According to the classification of Berndt and Harty, there are 4 stage II(4 in group I, 0 in group II), 19 stage III(9 in group I, 10 in group II), and 6 stage IV(1 in group I, 5 in group II). According to the ankle-hindfoot score, the mean score was significantly improved $53.1{\pm}2.7$ points preoperatively to $85.1{\pm}8.5$ points postoperatively in group I and $54.6{\pm}6.8\;to\;80.7{\pm}8.5$ points group II. Subjective and functional scores was also improved $49.6{\pm}10.5$ points preoperatively to $84.6{\pm}7.7$ points postoperatively in group I and $50.7{\pm}9.2\;to\;83.0{\pm}9.6$ points in group II. But there were no statistical significance between them. Conclusion: Arthroscopic debridement and multiple drilling for the treatment of osteochondral lesions of the talus showed successful results and there was no statistically significant difference between them.

• Journal of the Korean Arthroscopy Society
• /
• v.14 no.2
• /
• pp.131-134
• /
• 2010

Inappropriate treatment of osteochondral fracture can cause osteoarthritis, pain, functional disorder. With large osteochondral fracture, reduction and fixation of the fragment using metal implant. However, when the bone fragment had less than 2mm, the fragment extracted because of difficulty of fragment fixation. Authors treated patients with fracture fragment thickness less than 2mm of osteochondral dissecans in medial femoral condyle and patella fracture using biodegradable meniscus screw, and then we obtained good result.

• Clinics in Shoulder and Elbow
• /
• v.8 no.2
• /
• pp.63-67
• /
• 2005

Osteochondritis dissecans is a common cause of lateral elbow pain in throwing athletes and gymnasts between the age of 10 and 15 years. The pain frequently is insidious and progressive in nature and is relieved with rest in most cases. Compressive forces at the radiocapitellar joint along with a tenuous blood supply to the region may play a role in the etiology of this condition. Treatment is directed according to presenting symptoms, radiographic findings and status of the involved segment. Surgical management involves either an excision of a loose lesion and removal of loose bodies or reattachment of an osteochondral fragment. The role of subchondral penetration of debridement of the defect after fragment excision is unclear. Whether to excise and debride or to fix an unstale fragment is a highly controversial topic. The clinician should recognize osteochondritis dissecans of the elbow as a potentially disabling condition where the prognosis for return to sport is guarded

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.7 no.2
• /
• pp.75-83
• /
• 2008

과사용 증후군은 정상적인 조직에 최대하 부하(submaximal stress)가 지속되어 발생하는 것이다. 이와 같은 현상은 연부조직의 접합부(junction)에서 주로 일어나며 힘의 전달이 집중되는 곳, 조직의 역학적 성질이 변화되는 곳, 그리고 성장시 빨리 변화하는 성질이 있는 곳에 주로 생긴다. 근육의 불균형이 과사용 증후군의 가장 많은 원인이다. 과거의 부상 이후 부적절한 재활치료 및 각형성 또는 회전 부정정렬(angular and rotational malalignment) 등이 과사용 증후군의 원인이 될 수 있다. 스포츠 훈련 방법의 실수로도 과사용 증후군이 생길 수 있다. 전방 슬관절 동통시 감별해야 할 질환들은 jumper's knee, 슬개건염 혹은 대퇴 사두건염, Osgood-Schlatter 병, Sinding-Larsen-Johansson 병, 슬개골 연골 연화증, 슬개골 전(prepatellar) 혹은 슬개골 하(infrapatellar) 점액낭염, Hoffa's fat pad의 염증, 그리고 특발성 전방 슬관절 동통 증후군(idiopathic anterior knee pain syndrome)등이 있다. 후방 슬관절 통증의 원인 질환으로는 만성 슬와근 염좌, 슬괵건 점액낭염, 경골 골간단의 피로 골절 등이 포함되며 외측 슬관절 통증의 원인으로는 장경대 충돌 증후군(iliotibial band friction syndrome)등이 있을 수 있다. 이외 과사용 증후군과 관련된 슬관절 통증의 원인으로 다분 슬개골(multipartite patella), 내측 경골 스트레스 증후군(medial tibial stress syndrome), 박리성 골연골염, 반월상 연골의 퇴행성 변화 등이 있을 수 있다. 과사용 증후군의 진단 및 치료의 일반적인 접근법은 다섯가지 단계의 프로그램으로 요약될 수 있다. 첫째, 원인 요소를 확인하고, 둘째, 요소를 변경시키고, 셋째, 통증을 조절하고, 넷째, 능동적 재활을 시키고, 그리고 다섯째, 유지시키는 것이다.

• 대한상한금궤의학회지
• /
• v.15 no.1
• /
• pp.161-182
• /
• 2023

Objective: This is the result of a study on patients with osteochondritis dissecans (OCD) of the talus whose pain was improved by Gamchobuja-tang (GBT). Methods: The patient took GBT for 46 days. We observed the progress of symptoms, patient compliances and side effects. Quality of life related to pain was quantified through the SF-36 and AQoL-6D questionnaires. The degree of pain in the talus and ankle areas was quantified using VAS and observed through the symptoms and frequency complained of by the patient. Results: According to the DPIDS, the patient was diagnosed with the 175 provision in Taeyangbing chestbind (大陽病 結胸). As a result, SF-36 score increased from 36 points to 74 points, and the AQoL-6D score increased from 74 points to 104 points. The visual analogue scale (VAS) of ankle pain lowered from 9 to 2. The number of days with VAS levels 1 also increased. Conclusions: Gamchobuja-tang is effective in reducing pain in the talus area caused by osteochondritis dissecans..

• Journal of Haehwa Medicine
• /
• v.22 no.1
• /
• pp.225-233
• /
• 2013

Objective : The objective of this study is to observe the effect of anti-inflammatory herbal acupuncture, acupuncture, physical theraphy, external treatment, therapeutic exercise on the osteochondritis dissecans. Methods : Anti-inflammatory herbal acupuncture and acupuncture were used to treat knee pain and gait disturbance. We evaluated the patient through VAS(visual analogue scale) daily and symptoms. Results & Conclusions : After 31 days of treatment, right knee pain was decreased from VAS 10 to VAS 4, redness, burning sensation, edemaright of right knee were decreased. And the patient could walk. Oriental medicine treatment is proved to be helpful to imporve the symptoms of the osteochondritis dissecans.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.1 no.1
• /
• pp.49-54
• /
• 2002

Purpose : To analyze the clinical results of treatment for the osteochondritis dissecans of femoral condyle by age, the type of lesion and method of treatment. Methods : From March 1991 to February 2000, 17 patients (20 cases) with osteochondritis dissecans of the femoral condyle were followed up over 1 year. Three patients had bilateral lesion. There were 12 cases with trauma history (9 cases with sports injury and 3 cases with direct trauma). The initial symptoms were pain, clicking, locking, giving way in the order of frequency, pain was revealed in all cases. Clinical evaluation of IKDC and Hughston method were used for subjective and objective function. Results : The number of male patient was 12, and the mean age was 19.8 year old (11$\~$50). The location of the lesion was 14 cases in medial femoral condyle and 6 cases in lateral femoral condyle. The arthroscopic findings of the lesion in 15 cases were as follows, early separation in 6 cases, partially detachment in 4 cases, and crators and complete detachment in 5 cases. 5 cases were treated with mutiple drilling and 5 cases with Herbert screw fixation, 3 cases with Herbert screw fixation and bone graft. In early stage, 7 cases were treated with conservative method. In the grading of Hughston score, 6 cases were graded as excellent, 9 cases as good, 15 cases were graded as good to excellent. Based on the IKDC scale, 1 case was graded as normal, 6 as nearly normal, and 10 as abnormal. Conclusions : The trauma seemed to be important factor in occurrence of osteochondritis dissecans of the femoral condyle. The clinical results of juvenile period showed better than adolescence and adult period, it is necessary to detect the lesion as soon as possible. The result of subjective evaluation was worse than the Hughston evaluation. It was caused by limiting involvement of sports activity and limited activity in the adolescence.

• Journal of Korean Foot and Ankle Society
• /
• v.6 no.2
• /
• pp.190-194
• /
• 2002

Purpose: We present our experience about the clinical aspect and treatment modalities of ostechondritis dissecans of the talus. Material and Method: This study included 35 patients, 38 cases diagnosed as ostechondritis dissecans of the talus that were proved by clinical and radiologic finding. The methods of treatment were conservative (2 cases), multiple drilling (1 case), excision (1 case), excision, curettage & multiple drilling (23 cases), curettage & bone peg fixation (2 cases), curettage & bone graft (2 cases), and autogenous osteochondral transfer(Mosaicplasty) (7 cases). Results: Of the 38 cases, 30 cases were associated with a history of trauma (17 cases of medial lesion, 13 cases of lateral lesion), and 9 cases of which had major trauma history and 21 cases, minor repetitive trauma history. According to O'Farrel grading system, 21 cases (55%) had good results, 11 cases (29%) had fair results, and 6 cases (16%) had poor results. Of the medial lesion 16 cases had good results, 6 cases, fair results, and 2 cases, poor results. Of the lateral lesion 5 cases had good results, 5 cases, fair results, and 4 cases, poor results. Conclusion: There were fair or good results in 84% of patients with surgical treatment. Curettage and multiple drilling reveals a good result in medial lesion in grade I, II, III and lateral lesion in grade I, II. Autogenous osteochondral transfer(Mosaicplasty) is considered for the cases in grade III, IV(medial and lateral), lesion exceeds 1Cm of size and poor result with another treatment modality.

• The Korean journal of sports medicine
• /
• v.36 no.4
• /
• pp.180-188
• /
• 2018

Purpose: The purpose of this study is to identify bilateral differences of physeal closure of the lateral compartment of the elbow in osteochondritis dissecans (OCD) and related factors with premature physeal closure. Methods: Initial radiographs of the bilateral elbows in 40 baseball players with OCD (group I) were reviewed for the status of physeal closure of the lateral compartment; capitellum, radial head, lateral epicondyle. Forty baseball players with medial epicondylar apophysitis (group II) were enrolled as a control. Relative status of physeal closure of dominant elbow was defined as early, same, and delayed. Bilateral differences of the status of physeal closure were analyzed between groups, and according to the radiographic stages, extent of the lesions and demographic factors in group I. Results: Significant early physeal closures of dominant elbows were identified in group I in capitellum (group I, 55%; group II, 3%), radial head (group I, 53%; group II, 3%), and lateral epicondyle (group I 37%; group II, 5%). In group I, advanced stage and extended lesion showed early lateral compartment physeal closure especially in capitellum and radial head, and players with longer career length and limitation of motion showed early closure. Conclusion: Over the half of the adolescent baseball players with OCD demonstrated early radiocapitellar physeal closures of dominant elbow in initial presentation. Because premature physeal closure contributes to the development of arthritis without appropriate radiocapitellar remodeling, early detection of OCD is essential for prevention of arthritis and successful conservative management.