N. Van Egmond (Leusden, NL)

UMC Utrecht Orthopaedics
Nienke is an orthopaedic surgeon at the Department of Orthopedic Surgery at the University Medical Center (UMC) Utrecht; The Netherlands. In 2018; she finished her PhD research (Joint Preservation of Unicompartmental Knee Osteoarthritis). In 2018 and 2019; she did a knee fellowship under supervision of Prof Daniel Saris and Roel Custers at the UMC Utrecht. Her primary interest is knee surgery; especially joint preservation treatments (cartilage repair; osteotomies and knee joint distraction); but also knee (revision) arthroplasty. She is working as a knee surgeon at the Mobility Clinic; which is a multidisciplinary clinic; with a special expertise in young patients with complex knee pathology. She is collaborating in several research trials (basic and clinical research); with a main focus on knee joint preserving treatments and regenerative medicine. The Department of Orthopedic Surgery at the UMC Utrecht has a long-lasting fruitful research collaboration with the Department of Rheumatology of the UMC Utrecht.

Presenter Of 1 Presentation

 ICRS 2022 - Online Programme
Podium Presentation Clinical Outcome

18.2.1 - Osteochondritis Dissecans Associated With Mechanical Overload of the Knee Joint

Presentation Topic
Clinical Outcome
Date
14.04.2022
Lecture Time
14:15 - 14:24
Room
Potsdam 3
Session Name
18.2 - The Knee
Session Type
Free Papers
Speaker
Authors
Disclosure
No Significant Commercial Relationship

Abstract

Purpose

Osteochondritis dissecans (OCD) of the knee is a rare, invalidating disorder in which subchondral bone detaches, leading to an osteochondral fragment that can become unstable and progress into a loose body. The exact etiology is still unknown, although several biological and mechanical factors are described. We aim to give insight into epidemiological data of patients affected by OCD of the knee and to identify possible factors contributing to the etiology of this disorder.

Methods and Materials

A total of 222 patients (250 knees) affected by OCD were included in the UMC Utrecht Knee Registry (2005-2020) and retrospectively analyzed. Patient demographics were extracted from the medical records. Location and ICRS grade (I-IV) of OCD were assessed using MRI. If available, a full-leg standing radiograph was used to asses (mal)alignment.

Results

A total of 256 OCD lesions were identified in 250 knees, 64.4% on the medial femur condyle (MFC), 28.9% lateral femur condyle (LFC), 4.3% trochlea, 2.3% patella and 1.2% lateral tibia plateau. The male:female ratio was 1.3:1. A very high percentage of patients (71.2%, n=158) practiced sports, of which 70.3% (n=111) practiced high-impact sports. The location of OCD and the leg alignment (n=79) were statistically significantly correlated, MFC lesions had more varus than valgus alignment (40.0% vs 7.0%) and patients with LFC lesions had more valgus than varus alignment (46.2% vs 11.5%) (p=0.000). The mean ICRS grade was higher in patients reporting trauma prior to onset of symptoms (p=0.000).

Conclusion

This study provides insight into epidemiological data of 222 patients affected by OCD of the knee. There is an association between OCD of the MFC and varus malalignment and between OCD of the LFC and valgus malalignment. This, in combination with the high percentage of patients practicing (high-impact) sports, suggests an important role for mechanical overload in the pathogenesis of OCD.

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