IC 204-2024: The Cutting Edge in Osteochondritis Dissecans: Updates from the ROCK Group-IC204_The Cutting Edge in Osteochondritis Dissecans Updates from the ROCK Group

Video Transcription

Video Summary

A panel presentation on the management of Osteochondritis Dissecans (OCD), particularly within the ROC group, took place. The panel included Dr. Shea, Dr. Ganley, Dr. Ellerman (who was absent), and Dr. Perkins, with various topics covered from the history of ROC, treatment strategies to specific case studies.<br /><br />Dr. Shea discussed the ROC group's formation in 2009, their objective of advancing research in OCD due to gaps in clinical evidence, and the creation of clinical guidelines which identified unresolved questions in the field. The guidelines emphasized the importance of robust observational studies, prospective cohorts, and randomized clinical trials (RCTs). Partnerships with experts and securing a grant from the Orthopedic Research and Education Foundation (ORF) facilitated ROC's initial steps.<br /><br />Dr. Ganley focused on the recent advancements and clinical studies in treating OCD, noting the importance of both inter-observer reliability and RCTs. The studies compared transarticular and retroarticular drilling techniques, finding both effective for stable lesions. Technical tips for these procedures were provided, such as using a core needle biopsy trocar to avoid pitfalls during transarticular drilling.<br /><br />Dr. Ellerman, whose section was presented in absentia, provided insights into the radiologic imaging of OCD lesions including T2 star imaging and its implications for following osseous healing. The presentation highlighted the importance of understanding vascular regression in the development of OCD lesions, stressing the utility of advanced imaging techniques in monitoring and predicting healing outcomes.<br /><br />Dr. Perkins discussed treatment principles of OCD, emphasizing the critical assessment of lesion stability and the importance of preserving native cartilage whenever possible. Various treatment methods were debated, including drilling for stable OCD, fixation options like suture bridge repairs, and the utilization of osteochondral allograft transplants for more severe, unstable lesions.<br /><br />The panel answered questions, elaborating on their preferences and recommendations, and stressed on factors like alignment, predictors of healing, and the use of braces or weight-bearing restrictions in different scenarios. The emphasis throughout the discussions was on individualized patient care, utilizing a combination of advanced imaging, careful clinical judgment, and a range of surgical and non-surgical interventions.

Keywords

Osteochondritis Dissecans

ROC group

Dr. Shea

Dr. Ganley

Dr. Ellerman

Dr. Perkins

clinical guidelines

RCTs

transarticular drilling

retroarticular drilling

T2 star imaging