Summary

In terms of OCD healing rate, there was no significant difference between normal type and incomplete discoid type. Since complete discoid type showed significantly meniscal symptoms and higher operation performing rate, careful follow-up would be necessary for OCD with complete discoid even if s

Abstract

Background

Osteochondritis dissecans (OCD) of lateral femoral condyle (LFC) is often reported in combination with discoid lateral meniscus (DLM). Treatment strategy for OCD is decided according to OCD stage and is obtained consensus. However there is few reports for clinical outcomes for OCD of LFC in each shape of lateral meniscus (normal, incomplete discoid, complete discoid).

Purpose

To evaluate clinical outcomes for OCD of LFC in each shape of lateral meniscus.

Methods

Eighty seven knees in 73 patients were diagnosed with symptomatic OCD of LFC. Of these 73 patients, 72 knees in 62 patients (mean 9.9 years) who were estimated shape of lateral meniscus on MRI were enrolled in our study. In our treatment strategy for OCD of LFC, patients with stable OCD and no meniscal symptom were received conservative treatment and patients with unstable OCD, meniscal symptom or invalid conservative treatment were received operative treatment. First, shape of lateral meniscus in all patients was evaluated. Second, in each shape of lateral meniscus, age, OCD stage (stable/unstable, according to Brückl classification), meniscal symptom, OCD healing rate by conservative treatment and operation performing rate were evaluated. Third, characteristics of patients with operation were evaluated.

Results

The most common type of meniscal shape shown by MRI was normal (36.6%; 26 knees). Incomplete discoid type was found in 24 knees (33.3%), complete discoid type in 22 knees (30.5%). There was no significant difference among the 3 shapes in age and OCD stage. Complete discoid type showed significantly meniscal symptoms (73%) (P<0.05) and higher operation performing rate (91%) (P<0.05). In terms of OCD healing rate, there were 22 knees (84.6%) in normal type and 20 knees (83.3%) in incomplete type. In characteristics of patients with operation (28 knees; 38.9%), older age, closed physis, meniscal symptoms and complete discoid type were significantly tend to operation (P<0.05).

Conclusion

In terms of OCD healing rate, there was no significant difference between normal type and incomplete discoid type. Therefore treatment strategy for OCD with incomplete discoid would be to think same as normal meniscus. Since complete discoid type showed significantly meniscal symptoms and higher operation performing rate, careful follow-up would be necessary for OCD with complete discoid even if stable OCD.