Osteochondritis Dissecans: Diagnosis and Treatment Options for Athletes
Preface
Matthew D. Milewski, MD Carl W. Nissen, MD Editors
We have been privileged to serve as editors for this issue of Clinics in Sports Medicine dedicated to Osteochondritis Dissecans (OCD). Since Ko¨nig1 first coined the term in 1887, this unique disease process has challenged health care providers as to its true etiology and treatment. A recent Clinical Practice Guidelines2 (CPG) sponsored by the American Academy of Orthopaedics Surgeons (AAOS) and put together by leading experts highlighted the lack of high-quality evidence-based definitive diagnostic and treatment recommendations. However, spurred by these findings, a group of international surgeons, musculoskeletal radiologists, physical therapists, and researchers formed the Research in Osteochondritis of the Knee (ROCK) group3 to try and answer these questions. Many of the articles are written by members of this prestigious group, who provide their vast experience and knowledge on the subject. The issue focuses on OCD, defined herein as “a focal, idiopathic alteration of subchondral bone with risk for instability and disruption of adjacent articular cartilage that may result in premature osteoarthritis”4 with particular attention to student-athletes. The invited authors clearly shed light on the pathophysiology, possible etiologies, including genetic predisposition, imaging characteristics, unique rehabilitation strategies, and treatment options ranging from nonoperative conservative strategies to salvage procedures, and even future cutting-edge options. While much of the focus in this issue centers on OCD of the knee, individual articles are also dedicated to OCD of the elbow, talus, shoulder, and hip. We hope that this issue serves the reader in shedding light on this unique disease process to improve provider and patient education, understand the various treatment strategies and possible outcomes, and spur further interest in researching this disease
Clin Sports Med 33 (2014) xiii–xiv http://dx.doi.org/10.1016/j.csm.2014.01.005 0278-5919/14/$ – see front matter Ó 2014 Published by Elsevier Inc.
sportsmed.theclinics.com
xiv
Preface
process to improve the care of athletes and all patients and families affected by Osteochondritis Dissecans. Matthew D. Milewski, MD Elite Sports Medicine Connecticut Children’s Medical Center Farmington, CT 06032, USA University of Connecticut School of Medicine Farmington, CT 06030, USA Carl W. Nissen, MD Elite Sports Medicine Connecticut Children’s Medical Center Farmington, CT 06032, USA University of Connecticut School of Medicine Farmington, CT 06030, USA E-mail addresses: [email protected] (M.D. Milewski) [email protected] (C.W. Nissen) REFERENCES
1. Ko¨nig F. Ueber freie Ko¨rper in den Gelenken. [On loose bodies in the joint]. Dtsch Z Chir 1887;27:90–109. 2. Chambers HG, Shea KG, Carey JL. AAOS Clinical Practice Guideline: diagnosis and treatment of osteochondritis dissecans. J Am Acad Orthop Surg 2011;19: 307–9. 3. Research in Osteochondritis Dissecans of the Knee (ROCK) Group. Available at: http://www.osteochondritisdissecans.org and http://www.kneeocd.org. Accessed January 3, 2014. 4. Edmonds EW, Shea KG. Osteochondritis dissecans. Editorial comment. Clin Orthop Relat Res 2013;471:1105–6.
Preface
Matthew D. Milewski, MD Carl W. Nissen, MD Editors
We have been privileged to serve as editors for this issue of Clinics in Sports Medicine dedicated to Osteochondritis Dissecans (OCD). Since Ko¨nig1 first coined the term in 1887, this unique disease process has challenged health care providers as to its true etiology and treatment. A recent Clinical Practice Guidelines2 (CPG) sponsored by the American Academy of Orthopaedics Surgeons (AAOS) and put together by leading experts highlighted the lack of high-quality evidence-based definitive diagnostic and treatment recommendations. However, spurred by these findings, a group of international surgeons, musculoskeletal radiologists, physical therapists, and researchers formed the Research in Osteochondritis of the Knee (ROCK) group3 to try and answer these questions. Many of the articles are written by members of this prestigious group, who provide their vast experience and knowledge on the subject. The issue focuses on OCD, defined herein as “a focal, idiopathic alteration of subchondral bone with risk for instability and disruption of adjacent articular cartilage that may result in premature osteoarthritis”4 with particular attention to student-athletes. The invited authors clearly shed light on the pathophysiology, possible etiologies, including genetic predisposition, imaging characteristics, unique rehabilitation strategies, and treatment options ranging from nonoperative conservative strategies to salvage procedures, and even future cutting-edge options. While much of the focus in this issue centers on OCD of the knee, individual articles are also dedicated to OCD of the elbow, talus, shoulder, and hip. We hope that this issue serves the reader in shedding light on this unique disease process to improve provider and patient education, understand the various treatment strategies and possible outcomes, and spur further interest in researching this disease
Clin Sports Med 33 (2014) xiii–xiv http://dx.doi.org/10.1016/j.csm.2014.01.005 0278-5919/14/$ – see front matter Ó 2014 Published by Elsevier Inc.
sportsmed.theclinics.com
xiv
Preface
process to improve the care of athletes and all patients and families affected by Osteochondritis Dissecans. Matthew D. Milewski, MD Elite Sports Medicine Connecticut Children’s Medical Center Farmington, CT 06032, USA University of Connecticut School of Medicine Farmington, CT 06030, USA Carl W. Nissen, MD Elite Sports Medicine Connecticut Children’s Medical Center Farmington, CT 06032, USA University of Connecticut School of Medicine Farmington, CT 06030, USA E-mail addresses: [email protected] (M.D. Milewski) [email protected] (C.W. Nissen) REFERENCES
1. Ko¨nig F. Ueber freie Ko¨rper in den Gelenken. [On loose bodies in the joint]. Dtsch Z Chir 1887;27:90–109. 2. Chambers HG, Shea KG, Carey JL. AAOS Clinical Practice Guideline: diagnosis and treatment of osteochondritis dissecans. J Am Acad Orthop Surg 2011;19: 307–9. 3. Research in Osteochondritis Dissecans of the Knee (ROCK) Group. Available at: http://www.osteochondritisdissecans.org and http://www.kneeocd.org. Accessed January 3, 2014. 4. Edmonds EW, Shea KG. Osteochondritis dissecans. Editorial comment. Clin Orthop Relat Res 2013;471:1105–6.
