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Quantifying Risk Factors for Osteochondritis Dissecans in Children: A Propensity-Matched Retrospective Cohort Study
Joseph A Magoline1, Daniel F Wagner2, David C Kaelber3
1Department of Orthopedics, Akron Children's Hospital, Akron, Ohio, USA.
Orthopaedic Journal of Sports Medicine
|August 15, 2026
Summary
This study found that certain sports like gymnastics and medical conditions such as thrombophilia significantly increase the risk of osteochondritis dissecans (OCD) in young patients. Understanding these risk factors is crucial for prevention and early intervention in pediatric orthopaedics.
Area of Science:
- Pediatric Orthopaedics
- Epidemiology
- Sports Medicine
Background:
- Osteochondritis dissecans (OCD) is a developmental pediatric orthopedic condition affecting cartilage vascular supply, leading to joint degeneration.
- While repetitive trauma is a known factor, biological and hereditary predispositions are increasingly recognized.
- Understanding these factors is key to managing OCD in young populations.
Purpose of the Study:
- To quantify the relative risk (RR) of developing OCD in relation to specific biological comorbidities and athletic activities.
- To analyze a large, representative population of pediatric and adolescent patients.
- To update epidemiologic trends and identify novel risk associations for OCD.
Main Methods:
- A cross-sectional study utilizing the TriNetX US Collaborative Network (2017-2024) for patients aged 25 years and under.
- International Classification of Diseases (ICD-10) codes identified patients with OCD and associated conditions (e.g., hypopituitarism, coagulopathies, obesity).
- Propensity matching was used to calculate the relative risk (RR) of OCD associated with specific medical conditions and sports participation.
Main Results:
- 18,493 patients with OCD were identified; the knee was the most common site (49%).
- Annual OCD incidence increased from 15 to 23 per 100,000 between 2017 and 2024.
- High-risk sports included gymnastics (RR 4.96), volleyball (RR 2.96), and cheerleading (RR 2.83). Significant medical risk factors included primary thrombophilia (RR 3.20), von Willebrand Factor deficiency (RR 2.90), and Factor V Leiden (RR 2.70).
Conclusions:
- This large-scale analysis confirms associations between OCD and specific medical conditions and athletic participation in pediatric and adolescent populations.
- Novel links between OCD and coagulopathies (e.g., thrombophilia, von Willebrand Factor deficiency, Factor V Leiden) were identified.
- Updated epidemiologic data and quantified risk factors provide valuable insights for managing pediatric OCD.