DÄ internationalArchive50/2019Condylar Destruction in an 8-Year-Old Girl After Osteochondritis Dissecans

Clinical Snapshot

Condylar Destruction in an 8-Year-Old Girl After Osteochondritis Dissecans

Dtsch Arztebl Int 2019; 116: 857. DOI: 10.3238/arztebl.2019.0857b

Goebel, L; Kohn, D; Grün, U

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Magnetic resonance imaging, T2 TIRM sequence, sagittal reconstruction: the condylar fragment (#) is completely separated from the posterolateral femoral condyle by joint fluid (arrows). Insert: macroscopic view of the resected osteochondral fragment.
Magnetic resonance imaging, T2 TIRM sequence, sagittal reconstruction: the condylar fragment (#) is completely separated from the posterolateral femoral condyle by joint fluid (arrows). Insert: macroscopic view of the resected osteochondral fragment.
Figure 2
Magnetic resonance imaging, T2 TIRM sequence, sagittal reconstruction: the condylar fragment (#) is completely separated from the posterolateral femoral condyle by joint fluid (arrows). Insert: macroscopic view of the resected osteochondral fragment.

An 8-year-old girl presented to our department with an 18-month history of locking and swelling of her right knee joint. An urgent patient referral to our department, as advised by the primarily treating orthopedist, had not been carried out by the parents. Radiographs of the knee joint showed one large and several small bony fragments in projection of the posterolateral knee joint compartment. Magnetic resonance imaging confirmed an osteochondritis dissecans (incidence for the knee joint 3 to 6/10 000, peak onset in second decade of life) involving the entire posterolateral femoral condyle with a displaced osteochondral fragment (stage IV), advanced osteochondral defects, and loose bodies (Figure). Arthroscopy revealed a severe generalized synovitis. Multiple loose bodies were removed arthroscopically, and the large osteochondral fragment was removed through mini-arthrotomy (Insert). As a refixation of the condylar fragment was impossible, a microfracture treatment was performed to induce the formation of cartilaginous repair tissue. The patient remains under our follow-up. There have been no further complaints of pain or swelling, and no knee joint instability, even in flexion, has been reported.

Dr. med. Lars Goebel, Prof. Dr. med. Dieter Kohn, Dr. med. Ulrich Grün,
Klinik für Orthopädie und Orthopädische Chirurgie, Universitätsklinikum des Saarlandes, Homburg/Saar, lars.goebel@uks.eu

Conflict of interest statement: The authors declare that no conflict of interest exists.

Translated from the original German by David Roseveare.

Cite this as: Goebel L, Kohn D, Grün U: Condylar destruction in an 8-year-old girl after osteochondritis dissecans.
Dtsch Arztebl Int 2019; 116: 857. DOI: 10.3238/arztebl.2019.0857b

Magnetic resonance imaging, T2 TIRM sequence, sagittal reconstruction: the condylar fragment (#) is completely separated from the posterolateral femoral condyle by joint fluid (arrows). Insert: macroscopic view of the resected osteochondral fragment.
Magnetic resonance imaging, T2 TIRM sequence, sagittal reconstruction: the condylar fragment (#) is completely separated from the posterolateral femoral condyle by joint fluid (arrows). Insert: macroscopic view of the resected osteochondral fragment.
Figure 2
Magnetic resonance imaging, T2 TIRM sequence, sagittal reconstruction: the condylar fragment (#) is completely separated from the posterolateral femoral condyle by joint fluid (arrows). Insert: macroscopic view of the resected osteochondral fragment.