Artikel
Osteochondritis dissecans of the lateral femoral condyle
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Autoren
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R. Schütz
- Universitätsklinikum Schleswig-Holstein, Campus Kiel, Orthopädische Klinik, Kiel
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W. Drescher
- Kiel
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D. Varoga
- Kiel
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J. Hassenpflug
- Kiel
| Veröffentlicht: | 13. Juni 2005 |
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Gliederung
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Introduction
Osteochondritis dissecans of the lateral knee condyle ocurrs more seldom than OD of the medial condyle (15% versus 85%). Its etiology remains unclear. We here report a case of OD of the lateral femoral condyle attempting to identify predisposing factors.
Case report
A twelve year old, adipous boy presented at the outpatient clinic with painful knee swelling after two episodes of falling onto his left knee. Range of mobility was limited to 90 degree of knee flexion, and a valgus leg axis with 6 cm intermalleolar distance. X-ray showed a dysplastic lateral condyle, and MR imaging revealed a dislocated osteochondral fragment in the weight-bearing zone of the lateral knee condyle, and cystic changes of the adjacent bone.
Arthroscopically, we found regularly shaped menisci, especially no discoid menisci, and normal cartilage surfaces. We took a biopsy from the bone adjacent to the fragment which histopathologically showed trabecular bone and normal fatty marrow. Consequently, we arthroscopically refixated the lose osteochondral fragment with two small fragment screws. The postoperative period was uncomplicated.
Discussion
We believe that the valgus axis of the knee, and the dysplastic lateral condyle may be important predisposing pathogenetic factors. The minor trauma experienced by our patient seems to be an additional pathogenetic factor. Also, OCD of the lateral femoral condyle appears in younger patients (mean age 14.2y) than OCD of the medial femoral condyle (mean age 21.5y; Mitsuoka et al. 1999).
