Kaiser Permanente Southern California, Los Angeles, California, USA.
St Luke's Sports Medicine, St Luke's Children's Hospital, Boise, Idaho, USA.
Am J Sports Med. 2018 Jun;46(7):1592-1595. doi: 10.1177/0363546518764676. Epub 2018 Apr 3.
Osteochondritis dissecans (OCD) has frequently been described in children and adolescents, but cases of OCD in adults are certainly encountered. Little has been published on the epidemiology of OCD in adult patients.
To assess the frequency of OCD lesions in adults and assess the risk by age, sex, and ethnicity.
Descriptive epidemiology study.
The authors assessed all patients aged 20 to 45 years from the entire database of patients enrolled as members of Kaiser Permanente Southern California from January 2011 until December 2013. Kaiser Southern California is an integrated health care system serving a racially, ethnically, and socioeconomically diverse population of >3.5 million patients. A retrospective chart review was done on OCD during this period. Inclusion criteria included OCD of any joint. Exclusion criteria included traumatic osteochondral fractures and coexistence of intra-articular lesions other than OCD. Joint involvement/location, laterality, and all patient demographics were recorded.
Among 122 patients, a total of 124 OCD lesions were found. The majority of lesions were in the ankle (n = 76) and knee (n = 43), with 3 foot lesions and 2 elbow lesions identified. OCD lesions were identified in 75 men (62%) and 47 women (38%). Overall incidence rates per 100,000 person-years were 3.42 for all OCD, 2.08 for ankle OCD, and 1.21 for knee OCD. The relative risk of adult OCD for men was twice that of women. The relative risk of adult OCD for white patients was 2.3 that of Asians and 1.7 that of Hispanics. Risk of knee OCD was 3.6 times higher for men than women. As compared with women, men had a higher risk for lateral femoral condyle OCD lesions versus the medial femoral condyle ( P = .05; odds ratio [OR], 5.19).
This large cohort study of Southern California adults with OCD demonstrated an increased OR for men (vs women) of OCD in all joints. The majority of symptomatic lesions were present in the ankle rather than the knee, as previously found in children. White and black patients had the highest OR of OCD; men had a significantly greater OR of lateral femoral condyle knee lesions as compared with women.
剥脱性骨软骨炎（OCD）在儿童和青少年中经常被描述，但成人中也有 OCD 病例。关于成人 OCD 的流行病学，发表的内容很少。
评估成人 OCD 病变的频率，并按年龄、性别和种族评估风险。
描述性流行病学研究。
作者评估了 2011 年 1 月至 2013 年 12 月期间加入 Kaiser Permanente Southern California 的所有 20 至 45 岁患者的整个数据库中的患者。Kaiser Southern California 是一个综合性医疗保健系统，为超过 350 万的患者提供服务，患者的种族、民族和社会经济背景各不相同。在此期间，对 OCD 进行了回顾性图表审查。纳入标准包括任何关节的 OCD。排除标准包括创伤性骨软骨骨折和除 OCD 以外的关节内病变并存。记录关节受累/部位、侧别和所有患者的人口统计学资料。
在 122 名患者中，共发现 124 处 OCD 病变。大多数病变位于踝关节（n=76）和膝关节（n=43），发现 3 处足部病变和 2 处肘部病变。75 名男性（62%）和 47 名女性（38%）中有 OCD 病变。所有 OCD 的每 10 万人年发生率为 3.42，踝关节 OCD 为 2.08，膝关节 OCD 为 1.21。男性 OCD 的相对风险是女性的两倍。白人患者发生成人 OCD 的相对风险是亚洲人的 2.3 倍，是西班牙裔的 1.7 倍。与女性相比，男性膝 OCD 的风险高 3.6 倍。与女性相比，男性股骨外侧髁 OCD 病变的风险更高（P=.05；优势比[OR]，5.19）。
这项针对南加州 OCD 成人的大型队列研究表明，所有关节中男性（与女性相比）的 OCD 比值比（OR）增加。与之前在儿童中发现的情况一样，大多数有症状的病变位于踝关节，而不是膝关节。白人患者和黑人患者的 OCD 发生率最高；与女性相比，男性股骨外侧髁膝部病变的 OR 显著更高。
