Bilateral knee and bilateral elbow osteochondritis dissecans

Area of Science:

• Orthopedics
• Pediatric Rheumatology
• Sports Medicine

Background:

• Osteochondritis dissecans (OCD) is a joint condition involving damage to cartilage and underlying bone.
• Bilateral and multi-joint involvement of OCD, particularly in the patella and elbow, is uncommon in adolescents.
• Previous conservative management for the patient's bilateral knee and elbow pain was unsuccessful.

Purpose of the Study:

• To report a unique case of bilateral patellar and elbow osteochondritis dissecans in an adolescent.
• To describe the diagnostic and therapeutic approach for this rare presentation.
• To highlight the successful surgical outcomes for managing these osteochondritis dissecans lesions.

Main Methods:

• Radiographic evaluation of bilateral knees and elbows.
• Arthroscopic removal of osteochondritis dissecans lesions and chondroplasty of the right patella.
• Arthroscopic/arthrotomy removal of loose osteochondral bodies from the left elbow.

Main Results:

• Osteochondritis dissecans lesions were identified in both patellas and bilateral elbows.
• Successful surgical removal of lesions and loose bodies resulted in full, painless range of motion in the left elbow.
• The patient experienced no operative complications, with a 2+ effusion noted in the right knee at 12-week follow-up.

Conclusions:

• This is the first reported case of coexisting bilateral patellar and elbow osteochondritis dissecans in an adolescent.
• Surgical management, including arthroscopy and chondroplasty, can be effective for treating complex osteochondritis dissecans presentations.
• Early diagnosis and intervention are crucial for managing osteochondritis dissecans to prevent long-term joint damage.