gms | German Medical Science

54. Jahrestagung der Norddeutschen Orthopädenvereinigung e. V.

Norddeutsche Orthopädenvereinigung

16.06. bis 18.06.2005, Hamburg

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Osteochondritis dissecans of the lateral femoral condyle

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  • corresponding author R. Schütz - Universitätsklinikum Schleswig-Holstein, Campus Kiel, Orthopädische Klinik, Kiel
  • W. Drescher - Kiel
  • D. Varoga - Kiel
  • J. Hassenpflug - Kiel

Norddeutsche Orthopädenvereinigung. 54. Jahrestagung der Norddeutschen Orthopädenvereinigung e.V.. Hamburg, 16.-18.06.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05novEP56

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/nov2005/05nov135.shtml

Published: June 13, 2005

© 2005 Schütz et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

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).