Osteochondritis dissecans of the knee: a clinical survey

In osteochondritis dissecans a fragment of articular cartilage together with subchondral bone becomes separated partly or completely from a joint surface. It is an avascular segment that separates, and this distinguishes it from acute osteochondral fracture. In this study a clinical evaluation of the etiological factors has been made, and from an assessment of the results of various treatments a plan of management of the knee joint affected by this disease has been formulated. Osteochondritis dissecans may be found in many joints but it is most common in the knee. It is often unilateral but bilateral and symmetrical lesions are not unusual. Lesions may cause symptoms but some are “silent”, especially in the elbow and ankle. The cause of the separation of the fragment has been the subject of much discussion and many theories over the past century. There have been two main schools: one supporting injury (Paget I 870, Konig 1 887, Fairbank 1933), and the other supporting vascular insufficienc