1/3. A young wrestler with antecedent both-knee Osgood Schlatter's disease and JOCD.A 15-yr-old high school wrestler with an antecedent history of bilateral knee Osgood Schlatter's disease and juvenile osteochondritis dissecans (JOCD) presented with a 6-month complaint of episodic bilateral knee pain. history and physical examination results were consistent with a diagnosis of patello-femoral dysfunction secondary to prior intraarticular knee pathology. Radiographic evaluation demonstrated resolution of the previous osteochondral defects in both femoral condyles. After participating in a short course of supervised rehabilitation, the athlete was able to return to full activity. review of the patient's record since initial diagnosis of bilateral Osgood Schlatter's disease and JOCD suggested a delay in diagnosis secondary to previously existing knee pathology. informed consent was obtained from the subject and respective guardian prior to preparation of this case review.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/3. The results of operative treatment of osteochondritis dissecans of the patella.The course of osteochondritis dissecans (OCD) of the patella and the results of operative treatment are analyzed retrospectively in a review of 31 operatively treated cases in 25 patients. Followup was obtained for 21 cases, with an average of 73 months (range, 15 months to 20 years). These 25 patients were predominantly males, and averaged 18 years of age at the time of surgery. A history of trauma was associated with the lesion in 38% of the cases, and the lesion was bilateral in one out of four patients. The most common presenting complaints were subpatellar pain and swelling. The most common initial physical findings were patellofemoral crepitus and joint effusion. Forty-four operations were performed on 31 knees. The most commonly performed procedures were curettage of the patella and removal of loose bodies, in combination or as part of another procedure. A new patellofemoral rating scale was used to evaluate results. Thirty-eight percent of the knees had a good or excellent result, while 62% had a fair or poor result. Persistent pain with restricted function and residual patellofemoral crepitus were common findings. In general, the patients who come to surgery for OCD of the patella have a guarded prognosis for full recovery of knee function.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/3. osteochondrosis of the humeral capitellum.Seven cases of osteochondrosis of the capitellum occurring in five high performance female gymnasts between the ages of 11 and 13 are presented. Two of the patients were treated by surgical excision of the loose osteochondral fragment in three elbows. Four of the five gymnasts, including the two who underwent surgical treatment, were able to return to full workouts without recurrence of symptoms within the 3 year followup. All conditions in gymnasts were detected after symptoms had presented. A survey of 37 actively competing gymnasts at a nationally known gymnastics academy was performed, including a detailed history and physical examination and radiographic examination. No other cases of osteochondrosis were detected. It was postulated that this condition represents a lateral compression injury because of repetitive valgus overload. Investigation of the capitellar blood supply indicates that the common factors in osteochondrosis of the capitellum are repetitive or prolonged trauma to a vulnerable epiphysis on a basis of vascular interruption. gymnastics maneuvers require forceful weight-bearing through the upper extremities. Medical personnel and coaches associated with gymnastics need to be aware of the condition of osteochondrosis of the capitellum so that any gymnast who presents with a painful, tender, swollen or locked elbow is appropriately investigated and treated.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |