BOOK
Osteochondritis Dissecans: Diagnosis and Treatment Options for Athletes: An Issue of Clinics in Sports Medicine, E-Book
(2014)
Additional Information
Book Details
Abstract
This issue of Clinics in Sports Medicine will include the diagnosis and treatment of Osteochondritis Dissecans in athletes. Osteochondritis Dissecans, a joint condition in which a piece of cartilage, along with a thin layer of the bone beneath it, comes loose from the end of a bone. It is most common in the knee; however it can occur in other joints. Those individuals who frequently participate in strenuous sports, particularly young athletes, or perform repetitive activities that put the joint under stress, are at an increased risk of developing Osteochondritis Dissecans.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Osteochondritis Dissecans:Diagnosis and Treatment Options for Athletes | i | ||
| copyright\r | ii | ||
| Contributors | iii | ||
| Contents | vii | ||
| Clinics In Sports Medicine\r | xi | ||
| Preface | xiii | ||
| References | xiv | ||
| Osteochondritis Dissecans of the Knee | 181 | ||
| Key points | 181 | ||
| Introduction | 181 | ||
| Causes of OCD | 182 | ||
| Inflammatory Causes | 182 | ||
| Vascular/Ischemic Causes | 182 | ||
| Trauma/Microtrauma | 182 | ||
| Hereditary/Genetic Causes | 183 | ||
| Endochondral Ossification/Secondary Centers of Ossification | 183 | ||
| Epidemiology of OCD | 183 | ||
| Diagnosis of OCD | 184 | ||
| Summary | 185 | ||
| References | 185 | ||
| A Review of Arthroscopic Classification Systems for Osteochondritis Dissecans of the Knee | 189 | ||
| Key points | 189 | ||
| Introduction | 189 | ||
| Review of the literature | 190 | ||
| Radiographic and MRI Classifications | 190 | ||
| Arthroscopic Classification Systems for OCD of the Knee | 191 | ||
| Discussion | 194 | ||
| Summary | 196 | ||
| References | 196 | ||
| Emerging Genetic Basis of Osteochondritis Dissecans | 199 | ||
| Key points | 199 | ||
| Introduction | 199 | ||
| Methods | 200 | ||
| Review | 202 | ||
| Human | 202 | ||
| Equine | 202 | ||
| Swine | 207 | ||
| Discussion | 207 | ||
| Candidate Genes Cluster into Distinct Groups | 207 | ||
| Extracellular Matrix Proteins | 208 | ||
| Secreted Proteins Associated with Skeletal Dysplasia and/or OCD | 208 | ||
| Other Secreted Proteins | 209 | ||
| Secretory Pathway Proteins | 209 | ||
| Cell Signaling Pathways and Growth Plate Maturation | 209 | ||
| Summary | 211 | ||
| Acknowledgments | 215 | ||
| References | 215 | ||
| Imaging of Osteochondritis Dissecans | 221 | ||
| Key points | 221 | ||
| Knee | 221 | ||
| Imaging Diagnosis of OCD | 221 | ||
| Developmental Ossification Variation and Juvenile Osteochondritis Dissecans of the Distal Femur | 223 | ||
| Lesion Characteristics and Treatment Planning | 226 | ||
| Posttreatment Imaging: Expected Findings and Complications | 228 | ||
| Future Developments in MRI of OCD | 239 | ||
| Elbow | 240 | ||
| Ankle | 244 | ||
| Summary | 247 | ||
| References | 248 | ||
| Osteochondritis Dissecans of the Elbow | 251 | ||
| Key points | 251 | ||
| Introduction | 251 | ||
| Etiology and disease progression | 252 | ||
| Presentation and diagnosis | 253 | ||
| Nonoperative treatment | 256 | ||
| Operative treatment | 257 | ||
| Author’s surgical procedure of choice | 260 | ||
| Discussion | 263 | ||
| References | 263 | ||
| Osteochondritis Dissecans of the Talus | 267 | ||
| Key points | 267 | ||
| Introduction | 267 | ||
| Incidence | 268 | ||
| Anatomy and pathophysiology | 268 | ||
| History and physical examination | 269 | ||
| Imaging and classification | 270 | ||
| Nonoperative treatment | 271 | ||
| Operative treatment | 273 | ||
| Fragment Excision | 273 | ||
| Bone Marrow Stimulation | 274 | ||
| Microfracture | 275 | ||
| Osteochondral Autograft Transplantation | 276 | ||
| Osteochondral Allograft Transplantation | 277 | ||
| Chondrocyte Implantation | 277 | ||
| Complications | 278 | ||
| Authors’ preferred technique | 279 | ||
| Summary | 280 | ||
| References | 280 | ||
| Osteochondritis Dissecans of the Shoulder and Hip | 285 | ||
| Key points | 285 | ||
| Introduction | 285 | ||
| Shoulder OCD | 286 | ||
| Hip OCD | 288 | ||
| Summary | 292 | ||
| References | 293 | ||
| Nonoperative Treatment of Osteochondritis Dissecans of the Knee | 295 | ||
| Key points | 295 | ||
| Introduction | 295 | ||
| Etiology | 296 | ||
| Epidemiology | 296 | ||
| Patient presentation | 297 | ||
| Physical examination | 297 | ||
| Prognosis and natural history | 297 | ||
| Imaging | 298 | ||
| Advanced Imaging: Bone Scintigraphy and MRI | 298 | ||
| Nonoperative treatment | 299 | ||
| Indications | 299 | ||
| Nonoperative Regimens | 299 | ||
| Medication | 299 | ||
| Activity modification | 299 | ||
| Immobilization | 299 | ||
| Duration of Nonoperative Treatment and the Role of Imaging | 300 | ||
| Return to Sports and Follow-up | 300 | ||
| Outcomes of nonoperative treatment | 301 | ||
| Summary | 301 | ||
| References | 302 | ||
| Drilling Techniques for Osteochondritis Dissecans | 305 | ||
| Key points | 305 | ||
| Introduction | 305 | ||
| Transarticular drilling | 306 | ||
| Retroarticular drilling | 308 | ||
| Notch drilling | 310 | ||
| Authors’ preferred technique | 311 | ||
| Summary | 311 | ||
| References | 312 | ||
| The Knee | 313 | ||
| Key points | 313 | ||
| Introduction | 313 | ||
| Surgical techniques of internal fixation | 315 | ||
| Screw Fixation | 315 | ||
| Variable-pitch and cannulated screws | 315 | ||
| Biologic Fixation | 315 | ||
| Mosaicplasty and bone sticks | 315 | ||
| Other | 317 | ||
| Kirschner wire, biodegradable rods/darts/pins | 317 | ||
| Preferred postoperative management | 317 | ||
| Summary | 318 | ||
| References | 318 | ||
| Salvage Techniques in Osteochondritis Dissecans | 321 | ||
| Key points | 321 | ||
| Introduction | 321 | ||
| Debridement/Microfracture/Osteochondral autograft transplantations | 322 | ||
| Debridement | 322 | ||
| Marrow Stimulation | 322 | ||
| Osteochondral Autograft Transplantation | 322 | ||
| Fresh osteochondral allograft | 322 | ||
| Safety | 323 | ||
| Surgical technique | 323 | ||
| Clinical results | 324 | ||
| Future directions in allograft cartilage salvage | 325 | ||
| Autologous cartilage implantation | 326 | ||
| History | 326 | ||
| Histology | 326 | ||
| Indications | 326 | ||
| Surgical Technique | 326 | ||
| Results | 328 | ||
| Complications | 328 | ||
| Matrix-induced autologous cartilage implantation | 328 | ||
| Surgical technique | 328 | ||
| Future directions in cell-based cartilage salvage | 329 | ||
| Summary | 329 | ||
| References | 329 | ||
| Future Treatment Strategies for Cartilage Repair | 335 | ||
| Key points | 335 | ||
| Introduction | 335 | ||
| Advances in current restorative therapies | 336 | ||
| Promising cartilage tissue engineering: scaffolds, growth factors, stem cell therapy | 338 | ||
| Emerging technologies for improving regenerative therapies | 341 | ||
| Future directions of the tissue engineering therapy for AC defects | 342 | ||
| Summary | 345 | ||
| References | 345 | ||
| Physical Therapy Management of Patients with Osteochondritis Dissecans | 353 | ||
| Key points | 353 | ||
| Introduction | 353 | ||
| Role of Physical Therapy in Nonoperative Management of OCD | 354 | ||
| Nonoperative Rehabilitation of OCD of the Knee: Initial Phase | 356 | ||
| Nonoperative Rehabilitation of OCD of the Knee: Intermediate Phase | 357 | ||
| Nonoperative Rehabilitation of OCD of the Knee: Advanced Phase | 357 | ||
| Nonoperative Rehabilitation of OCD of the Elbow: Acute Phase | 358 | ||
| Nonoperative Rehabilitation of OCD of the Elbow: Intermediate Phase | 358 | ||
| Nonoperative Rehabilitation of OCD of the Elbow: Advanced Phase | 358 | ||
| Nonoperative Rehabilitation of OCD of the Elbow: Return-to Sport Phase | 360 | ||
| Nonoperative Management of OCD of the Ankle: Acute Phase | 361 | ||
| Nonoperative Rehabilitation of OCD of the Ankle: Intermediate Phase | 362 | ||
| Nonoperative Rehabilitation of OCD of the Ankle: Advanced Phase | 362 | ||
| Nonoperative Rehabilitation of OCD of the Ankle: Return-to-sport Phase | 362 | ||
| Role of Physical Therapy in Operative Management of OCD | 364 | ||
| Postoperative Rehabilitation of Knee OCD: Acute Phase | 364 | ||
| Postoperative Rehabilitation of Knee OCD: Intermediate Phase | 365 | ||
| Postoperative Rehabilitation of Knee OCD: Advanced Phase | 366 | ||
| Postoperative Rehabilitation of OCD of the Elbow | 366 | ||
| Postoperative Rehabilitation of Elbow OCD: Acute Phase | 366 | ||
| Postoperative Rehabilitation of Elbow OCD: Intermediate Phase and Advanced Phase | 368 | ||
| Postoperative Rehabilitation of Elbow OCD: Return-to-sport Phase | 369 | ||
| Postoperative Rehabilitation of Ankle OCD: Acute Phase | 369 | ||
| Postoperative Rehabilitation of Ankle OCD: Intermediate and Advanced Phase | 369 | ||
| Postoperative Rehabilitation of Ankle OCD: Return-to-sport Phase | 370 | ||
| Postoperative Rehabilitation of Ankle OCD: Ankle ACI | 370 | ||
| Sport Reintegration | 371 | ||
| Summary | 371 | ||
| References | 371 | ||
| Treatment Algorithm for Osteochondritis Dissecans of the Knee | 375 | ||
| Key points | 375 | ||
| Background | 375 | ||
| Clinical presentation and physical examination | 376 | ||
| Imaging | 376 | ||
| Treatment options for OCD in the athlete | 376 | ||
| Conservative Management | 376 | ||
| Surgical Management of OCD in the Athlete | 377 | ||
| Authors’ preferred treatment algorithm for elite athletes | 380 | ||
| Discussion | 380 | ||
| References | 380 | ||
| Index | 383 |