Management of bilateral osteochondritis dissecans of the trochlea in a skeletally immature patient

BMJ Case Rep. 2021 Jan 27;14(1):e239849. doi: 10.1136/bcr-2020-239849.

Abstract

Osteochondritis dissecans (OCD) lesions are injuries that occur more commonly in the skeletally immature population. In most cases, the aetiology is not well understood, but fortunately, many OCD lesions may heal on their own over time, particularly in skeletally immature patients with open physes. Conversely, if the lesion is considered unstable, surgical intervention may be required. This case demonstrates an especially rare presentation of bilateral OCD lesions within the lateral femoral trochlear facet. The lesions became symptomatic approximately 1 year apart without a specific injury. Non-operative treatment was not recommended in either case due to the size and instability of each lesion. The surgical treatment used an augmented microfracture technique. At 12 and 23 months after surgery, both knees remain asymptomatic and the patient has returned to their desired activities.

Keywords: knee injuries; orthopaedic and trauma surgery.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Arthroscopy / methods*
  • Bone Development*
  • Cartilage, Articular / transplantation*
  • Humans
  • Knee Joint / diagnostic imaging
  • Knee Joint / surgery*
  • Magnetic Resonance Imaging
  • Male
  • Osteochondritis Dissecans / diagnostic imaging
  • Osteochondritis Dissecans / surgery*
  • Platelet-Rich Plasma*
  • Tissue Scaffolds
  • Transplantation, Homologous