PRISM Sports Medicine, Hartford, Connecticut; Hartford Healthcare's Bone and Joint Institute, Hartford, Connecticut, USA.
Children's Hospital Colorado, Aurora, Colorado, USA.
Am J Sports Med. 2022 Jan;50(1):118-127. doi: 10.1177/03635465211057103. Epub 2021 Nov 24.
Osteochondritis dissecans (OCD) occurs most commonly in the knees of young individuals. This condition is known to cause pain and discomfort in the knee and can lead to disability and early knee osteoarthritis. The cause is not well understood, and treatment plans are not well delineated. The Research in Osteochondritis Dissecans of the Knee (ROCK) group established a multicenter, prospective cohort to better understand this disease.
To provide a baseline report of the ROCK multicenter prospective cohort and present a descriptive analysis of baseline data for patient characteristics, lesion characteristics, and clinical findings of the first 1000 cases enrolled into the prospective cohort.
Cross-sectional study; Level of evidence, 3.
Patients were recruited from centers throughout the United States. Baseline data were obtained for patient characteristics, sports participation, patient-reported measures of functional capabilities and limitations, physical examination, diagnostic imaging results, and initial treatment plan. Descriptive statistics were completed for all outcomes of interest.
As of November 2020, a total of 27 orthopaedic surgeons from 17 institutions had enrolled 1004 knees with OCD, representing 903 patients (68.9% males; median age, 13.1 years; range, 6.3-25.4 years), into the prospective cohort. Lesions were located on the medial femoral condyle (66.2%), lateral femoral condyle (18.1%), trochlea (9.5%), patella (6.0%), and tibial plateau (0.2%). Most cases involved multisport athletes (68.1%), with the most common primary sport being basketball for males (27.3% of cases) and soccer for females (27.6% of cases). The median Pediatric International Knee Documentation Committee (Pedi-IKCD) score was 59.9 (IQR, 45.6-73.9), and the median Pediatric Functional Activity Brief Scale (Pedi-FABS) score was 21.0 (IQR, 5.0-28.0). Initial treatments were surgical intervention (55.4%) and activity restriction (44.0%). When surgery was performed, surgeons deemed the lesion to be stable at intraoperative assessment in 48.1% of cases.
The multicenter ROCK group has been able to enroll the largest knee OCD cohort to date. This information is being used to further understand the pathology of OCD, including its cause, associated comorbidities, and initial presentation and symptoms. The cohort having been established is now being followed longitudinally to better define and elucidate the best treatment algorithms based on these presenting signs and symptoms.
剥脱性骨软骨炎（OCD）最常发生在年轻人的膝盖。这种疾病会导致膝盖疼痛和不适，并可能导致残疾和早期膝骨关节炎。其病因尚不清楚，治疗方案也不明确。研究剥脱性骨软骨炎的膝关节（ROCK）小组建立了一个多中心前瞻性队列，以更好地了解这种疾病。
提供 ROCK 多中心前瞻性队列的基线报告，并介绍前 1000 例入组前瞻性队列的患者特征、病变特征和临床发现的基线数据的描述性分析。
横断面研究；证据水平，3 级。
患者从美国各地的中心招募。收集了患者特征、运动参与情况、患者报告的功能能力和限制的测量结果、体格检查、诊断影像学结果和初始治疗计划等基线数据。对所有感兴趣的结果完成了描述性统计。
截至 2020 年 11 月，共有 17 家机构的 27 名骨科医生招募了 1004 例 OCD 膝关节，代表了 903 名患者（68.9%为男性；中位年龄为 13.1 岁；范围为 6.3-25.4 岁），入组了前瞻性队列。病变位于内侧股骨髁（66.2%）、外侧股骨髁（18.1%）、滑车（9.5%）、髌骨（6.0%）和胫骨平台（0.2%）。大多数病例涉及多运动运动员（68.1%），最常见的主要运动是男性的篮球（27.3%的病例）和女性的足球（27.6%的病例）。中位数儿科国际膝关节文献委员会（Pedi-IKCD）评分为 59.9（IQR，45.6-73.9），中位数儿科功能活动简明量表（Pedi-FABS）评分为 21.0（IQR，5.0-28.0）。初始治疗是手术干预（55.4%）和活动限制（44.0%）。当进行手术时，外科医生在术中评估中认为 48.1%的病例病变稳定。
多中心 ROCK 小组已经能够招募到迄今为止最大的 OCD 膝关节队列。这些信息正在被用于进一步了解 OCD 的病理学，包括其病因、相关合并症以及初始表现和症状。该队列现已建立并正在进行纵向随访，以更好地根据这些现有体征和症状确定和阐明最佳治疗方案。
