Osteochondritis Dissecans of the Patellofemoral Joint

• Published in: The American journal of sports medicine Vol. 28; no. 1; pp. 63 - 67
• Main Authors: Peters, Tracy A., McLean, Iain D.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA American Orthopaedic Society for Sports Medicine 01-01-2000; SAGE Publications; Sage Publications, Inc; Sage Publications Ltd
• Subjects: Abnormalities; Adolescent; Adult; Biological and medical sciences; Cartilage; Cartilage - pathology; Child; Clinical outcomes; Diseases of the osteoarticular system; Exercise Therapy; Female; Femur - pathology; Humans; Injuries; Juxtaarticular diseases. Extraarticular rhumatism; Knee; Knee Joint - pathology; Male; Medical procedures; Medical sciences; Osteochondritis Dissecans - pathology; Osteochondritis Dissecans - rehabilitation; Pain; Patella - pathology; Physiological aspects; Sports medicine; Human; Treatment; Osteochondritis dissecans; Diseases of the osteoarticular system; Arthropathy; Bone disease; Diagnosis; Femoropatellar joint
• DOI: 10.1177/03635465000280012201
• EISSN: 1552-3365
• ISSN: 0363-5465

Osteochondritis dissecans of the patellofemoral joint is an uncommon condition that may be the cause of anterior knee pain
or crepitus. We present the clinical features of 37 patients with osteochondritis dissecans lesions of the patellofemoral
joint (24 on the patella, 13 on the trochlear groove), including two patients with medial trochlear groove lesions, which
have not, to our knowledge, been previously reported. The osteochondral lesions involved the convex articular surfaces. The
median age of patients when first examined was 15 years, and 54% of patients had open epiphyses. These lesions were more common
in male patients than in female patients (four-to-one ratio). Osteochondritis dissecans of the patellofemoral joint can be
overlooked unless quality radiographs are viewed with care and, at arthroscopy, both the patella and trochlear groove are
assessed. Treatment depends on the symptoms, site, and nature of the lesion and the patient’s age. Nonoperative management
includes patellar taping and vastus medialis obliquus muscle exercises. Operative intervention is indicated for patients with
mechanical symptoms and includes arthroscopy, consisting of chondroplasty and removal of loose bodies, and lateral retinacular
release. In this study treatment generally improved the symptoms, but patients with articular cartilage loss had persistent
patellofemoral crepitus and discomfort.