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Osteonecrosis and osteochondritis
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Jason Mansell, Michael Whitehouse
The terms ‘osteochondrosis’ or ‘osteochondritis’ have for many years been applied to a group of conditions in which there is demarcation, and sometimes separation and necrosis, of a small segment of articular cartilage and bone. The affected area shows many of the features of ischaemic necrosis, including death of bone cells in the osteoarticular fragment and reactive vascularity and osteogenesis in the surrounding bone.
Kyphotic deformities of the spine
Published in Benjamin Joseph, Selvadurai Nayagam, Randall Loder, Ian Torode, Paediatric Orthopaedics, 2016
This disorder is usually seen in children over the age of ten years. Both pain and deformity usually accompany the thoracic kyphosis which is the site of deformity of true Scheuermann’s disease although the lumbar spine may also be affected.2 This disease may be more appropriately described as an osteochondritis. In the early stages of the disease mild wedging of the vertebrae or loss of signal in the anterior portion of the growing vertebrae and intervertebral discs may be evident on magnetic resonance imaging. There is often associated end plate irregularity and loss of disc height. Progressive notching of the anterior margins of the vertebrae and further wedging of the vertebral bodies occur (Figure 22.2). In the lumbar spine, pain rather than deformity is usually the presenting complaint although a modest kyphosis at the thoracolumbar junction can occur. The disease itself is self-limiting and resolves by the end of spinal growth, but the deformity may be permanent.
Trauma and orthopaedic surgery
Published in Janesh K Gupta, Core Clinical Cases in Surgery and Surgical Specialties, 2014
Nicole Abdul, Terence McLoughlin
The disease has been characterized as an osteochondritis. It is a rather enigmatic condition and, for reasons that are poorly understood, part of the femoral epiphysis or growth centre undergo avascular necrosis. This naturally leads to softening and potential deformation of the femoral head. The younger the child at presentation and being of male sex are associated with a better prognosis.
Factors associated with joint contractures in adults: a systematic review with narrative synthesis
Published in Disability and Rehabilitation, 2023
Hina Tariq, Kathryn Collins, Desiree Tait, Joel Dunn, Shafaq Altaf, Sam Porter
There are three different types of joint contractures based on the underlying tissue involved: myogenic, arthrogenic, and soft tissue contractures. Myogenic contractures denote a reduction in muscle length leading to a limitation in both active and PROM [2], commonly seen in neurological conditions, e.g., brain and spinal cord injury (SCI), multiple sclerosis (MS), and cerebral palsy (CP) or after a prolonged period of immobility such as bed confinement in the intensive care unit (ICU). Arthrogenic contractures are usually coupled with pain and involve prominent changes in bone, cartilage, and the joint capsule [5]. This may result from damage and/or tightening of connective tissue, such as in osteoarthritis (OA), systemic sclerosis (SSc), osteochondritis, and intra-articular fractures [6]. Finally, soft tissue contractures, also known as scar contractures, involve cutaneous, subcutaneous, and loose connective tissue around the joint [2]. These are frequently seen in soft-tissue injuries like burns and open wounds. Regardless of tissue involvement, all types of contractures significantly impact functional ability and physical mobility [7].
Bone morphological factors influencing cartilage degeneration in the knee
Published in Modern Rheumatology, 2018
Kenji Takahashi, Sanshiro Hashimoto, Shinji Kiuchi, Atsuya Watanabe, Hiroshi Nakamura, Futoshi Ikuta, Tomoyuki Okuaki, Tatsunori Kataoka, Tokifumi Majima, Shinro Takai
The study population initially comprised 350 consecutive patients with knee pain who underwent knee MRI examination at our institutions between January 2010 and February 2016. Patients with imaging findings of inflammatory arthritis, osteonecrosis, osteochondritis dissecans, tumor, local full-thickness cartilage injury, collateral/cruciate ligament tears, previous knee surgery, OA secondary to other causes (acute or chronic infection, metabolic abnormalities and intra-articular fracture), and severe OA (defined as Kellgren–Lawrence (KL) grade 3 or 4 [8] on plain X-ray or chondral defect of weight bearing areas on MRI) were excluded. In patients who had multiple MRI examinations, their first examination was used. After excluding 150 MRI examinations, the remaining 200 cases (female/male, 122/78; mean ± SD age, 48.7 ± 14.5 years; age range, 14–80 years) were enrolled.
Cost-effectiveness analysis of arthroscopic injection of a bioadhesive hydrogel implant in conjunction with microfracture for the treatment of focal chondral defects of the knee – an Australian perspective
Published in Journal of Medical Economics, 2022
George Papadopoulos, Sarah Griffin, Hemant Rathi, Amit Gupta, Bhavna Sharma, Dirk van Bavel
An osteochondral defect is a localized defect of the articular cartilage and the underlying bone (subchondral bone)1–3. Osteochondral defects of the knee occur due to the removal of a portion of the articular cartilage from the knee joint surface and could be a result of trauma, microtrauma, biological conditions (osteochondritis dissecans or osteonecrosis) or genetic factors4,5. Articular cartilage is avascular and has poor repair ability, therefore, any injury or damage to the cartilage can seriously affect joint function and mobility6. Clinically, osteochondral defects can manifest as pain, locking, stiffness, swelling and functional impairment of the affected joint4,5.