The Demographics and Epidemiology of Osteochondritis Dissecans of the Knee in Children and Adolescents

Author:

Kessler Jeffrey I.1,Nikizad Hooman2,Shea Kevin G.3,Jacobs John C.4,Bebchuk Judith D.5,Weiss Jennifer M.1

Affiliation:

1. Kaiser Permanente Southern California, Los Angeles, California

2. University of Illinois at Chicago College of Medicine, Chicago, Illinois

3. St Luke’s Sports Medicine, Department of Orthopedics, St Luke’s Children’s Hospital, Boise, Idaho

4. University of Utah School of Medicine, Salt Lake City, Utah

5. Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena, California

Abstract

Background: Osteochondritis dissecans (OCD) is a disorder of subchondral bone and articular cartilage whose incidence in children is not clearly known. Purpose: The purpose of this study was to assess the demographics and epidemiology of OCD of the knee in children. Study Design: Descriptive epidemiology study. Methods: A retrospective chart review of an integrated health system was performed on patients with OCD of the knee aged 2 to 19 years from 2007 to 2011, with over 1 million patients in this cohort. Lesion location, laterality, and all patient demographics were recorded. The incidence of OCD was determined for the group as a whole and by sex and age group (2-5 years, 6-11 years, and 12-19 years). Patient differences based on age, sex, and ethnicity were analyzed, and using multivariable logistic regression models, associations between age, sex, ethnicity, and diagnosis of OCD of the knee were evaluated. Results: One hundred ninety-two patients with 206 OCD lesions of the knee fit the inclusion criteria. No OCD lesion of the knee was found in 2- to 5-year-old children. One hundred thirty-one (63.6%) lesions were in the medial femoral condyle, 67 (32.5%) were in the lateral femoral condyle, 96 (50.0%) lesions were right sided, 82 (42.7%) were left sided, and 14 (7.3%) were bilateral. The incidence of patients with OCD of the knee aged 6 to 19 years was 9.5 per 100,000 overall and 15.4 and 3.3 per 100,000 for male and female patients, respectively. Those aged 12 to 19 years represented the vast majority of OCD, with an incidence of 11.2 per 100,000 versus 6.8 per 100,000 for those aged 6 to 11 years. For those aged 6 to 11 and 12 to 19 years, female patients had an incidence of 2.3 and 3.9 per 100,000, respectively, while male patients had an incidence of 11.1 and 18.1 per 100,000, respectively. Multivariable logistic regression analysis revealed a 3.3-fold increased risk of OCD of the knee in patients aged 12 to 19 years compared with those aged 6 to 11 years ( P < .001; 95% confidence interval [CI], 2.37-4.48), and male patients had 3.8 times a greater risk of OCD of the knee than female patients ( P < .001; 95% CI, 2.71-5.41). Based on race and ethnicity, blacks had the highest odds ratio of OCD of the knee compared with all other ethnic groups. Conclusion: In this population-based cohort study of pediatric OCD of the knee, male patients had a much greater incidence of OCD and almost 4 times the risk of OCD compared with female patients. Also, patients aged 12 to 19 years had 3 times the risk of OCD of the knee as compared with 6- to 11-year-old children.

Publisher

SAGE Publications

Subject

Physical Therapy, Sports Therapy and Rehabilitation,Orthopedics and Sports Medicine

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2. Osteochondritis Dissecans Lesions of the Knee: Evidence-Based Treatment;Journal of the American Academy of Orthopaedic Surgeons;2024-01-30

3. A Comparative Analysis of Osteochondritis Dissecans and Avascular Necrosis: A Comprehensive Review;Journal of Clinical Medicine;2024-01-04

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