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Is There a Connection Between Attention Deficit Hyperactivity Disorder and Osteochondritis Dissecans?

Kevin M Dale1, Andrew Livermore2, Rewais Hanna3

  • 1Vanderbilt University, Orthopedic Surgery, Nashville, TN.

The Iowa Orthopaedic Journal
|August 4, 2020
PubMed
Summary

Children with Osteochondritis Dessicans (OCD) of the distal femur show a higher prevalence of Attention Deficit/Hyperactivity Disorder (ADHD). ADHD is associated with worse outcomes for OCD lesions in children.

Keywords:
adhdattention deficit hyperactivity disorderdistal femurocdosteochondritis dessicans

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Area of Science:

  • Orthopedics
  • Pediatrics
  • Neurodevelopmental Disorders

Background:

  • Osteochondritis Dessicans (OCD) is a condition affecting the distal femur in skeletally immature patients.
  • Attention Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder in children.

Purpose of the Study:

  • To investigate the comorbidity of ADHD in pediatric patients with distal femur OCD lesions.
  • To evaluate the impact of ADHD on the treatment outcomes of OCD in children.

Main Methods:

  • Retrospective chart review of pediatric patients (males <16, females <14) with distal femur OCD from 2000-2012.
  • Comparison of ADHD prevalence between OCD patients and age-matched controls with anterior knee pain.
  • Analysis of OCD lesion grades and treatment outcomes in children with and without ADHD.

Main Results:

  • ADHD prevalence was significantly higher (23%) in children with OCD compared to controls (11%).
  • Initial OCD lesion grades were similar between groups.
  • Children with ADHD experienced significantly worse OCD lesion grades at final follow-up.

Conclusions:

  • Pediatric distal femur OCD is significantly more prevalent in children with ADHD.
  • ADHD may negatively impact the treatment course and outcomes of OCD lesions in children.