Osteochondritis dissecans: A multicenter study of the European Pediatric Orthopedic Society

To assess of the value of conservative and operative treatment of osteochon dritis dissecans of the knee, a multicenter study was performed. In 12 Euro pean countries, 798 cases of osteochondritis of the knee have been collecte d from 44 hospitals. Results were based on 452 patients with 509 affected k nees with minimum follow-up was 1 year (mean follow-up. 3 years and 11 mont hs) and sufficient data for evaluation: 61% were male patients; 39% female patients; 318 affected knees were found in juvenile patients; 191 affected knees were in adult or premature patients. The localization was the medial femoral condyle on the lateral side in 51% (typical site) of patients. Vari ous other sites were involved. Of the 509 affected knees, 154 were treated conservatively, 355 were treated surgically (many with multiple operations) . For evaluation, the initial situation (at the time of the diagnosis) was favorable in 198 patients (no effusion, diameter of the lesion <20 mm and n o gross dissection on imaging) and unfavorable (one of the parameters did n ot meet these prerequisites) in 311 patients. The results were better in yo ung patients than in adult patients. However, in the adolescent group, 22% of patients had abnormal knee at follow-up. The classical localization has a better prognosis than an unusual one. Patients with a favorable situation at diagnosis have significantly better results after conservative treatmen t than those who have undergone operation. When there are signs of dissecti on, the results are better after operative than after conservative treatmen t.