Comparison of the Healing Outcomes of Conservative Treatment for Stable Juvenile Osteochondritis Dissecans of the Lateral Femoral Condyle With Normal Lateral Meniscus and Incomplete Discoid Lateral Meniscus

J Pediatr Orthop. 2022 Jul 1;42(6):e649-e655. doi: 10.1097/BPO.0000000000002150. Epub 2022 Mar 29.

Abstract

Background: This study aimed to compare the healing outcomes of conservative treatment for osteochondritis dissecans (OCD) of the lateral femoral condyle with normal lateral meniscus and incomplete discoid lateral meniscus (DLM).

Methods: Forty-four knees in 37 juvenile patients (mean age 9.9 y) with stable OCD and whose lateral meniscus shape was normal or incomplete DLM were enrolled. All patients underwent conservative treatment with physical activities prohibited. For each lateral meniscus group, patient demographics including pretreatment Tegner activity scale, OCD stage, and Lysholm score, radiographic healing status; complete or incomplete healing at 3 months, 6 months, and 1 year, time to complete healing and post-treatment clinical scores were evaluated.

Results: There were 21 (47.8%) and 23 (52.3%) knees with normal menisci and incomplete DLM, respectively. At 3 months, 6 months, and 1 year after conservative treatment, healed OCD status was noted in 3 (14.3%), 12 (57.1%), and 19 (90.5%) knees of the normal type and in 3 (13.0%), 12 (52.2%), and 20 (86.9%) knees of the incomplete DLM type, respectively (P>0.05). The mean time to healing in each group was 198 and 181 days, respectively. No significant differences in terms of OCD healing rate at each time, time to healing, and post-treatment clinical scores were found between the groups.

Conclusion: No significant differences in the OCD healing rate or time to healing were found between the normal and incomplete DLM type. Therefore, treatment strategy for OCD with stable and asymptomatic incomplete DLM should be the same as that for those occurring with a normal meniscus.

MeSH terms

  • Arthroscopy
  • Child
  • Conservative Treatment
  • Femur / diagnostic imaging
  • Humans
  • Joint Diseases*
  • Knee Joint / diagnostic imaging
  • Magnetic Resonance Imaging
  • Menisci, Tibial / diagnostic imaging
  • Osteochondritis Dissecans* / diagnostic imaging
  • Osteochondritis Dissecans* / therapy
  • Retrospective Studies