Bilateral juvenile osteochondrosis dissecans in monozygotic twins: a case report.

AOCD Femoral condyle JOCD Osteochondral lesion Osteochondrosis dissecans

Journal

Journal of orthopaedic surgery and research
ISSN: 1749-799X
Titre abrégé: J Orthop Surg Res
Pays: England
ID NLM: 101265112

Informations de publication

Date de publication:
01 Apr 2024
Historique:
received: 05 11 2023
accepted: 15 03 2024
medline: 2 4 2024
pubmed: 2 4 2024
entrez: 2 4 2024
Statut: epublish

Résumé

The etiology of osteochondrosis dissecans (OCD), a chondropathy associated with detachment of the subchondral bone and the overlaying cartilage, is not yet fully understood. While repetitive physical exercise-related stress is usually assumed to be the main risk factor for the occurrence of OCD, genetic predisposition could have an underestimated influence on the development of the disease. We report a case of monozygotic twins with almost identical stages of bilateral osteochondrosis dissecans of the knee joint. In both patients, initially, a unilateral lesion occurred; despite restricted physical exercise, in the further course of the disease a lesion also developed on the contralateral side. While the lesion found most recently demonstrated an ongoing healing process at a 6-month follow-up, the other three lesions showed a natural course of healing under conservative treatment with significant clinical as well as radiological improvements after one year and complete consolidation in magnetic resonance imaging (MRI) after 2 years. There could be a genetic component to the development of OCD, although this has not yet been proven. Based on a two-year MRI follow-up, we were able to show the self-limiting characteristics of juvenile osteochondrosis dissecans.

Identifiants

pubmed: 38561825
doi: 10.1186/s13018-024-04683-2
pii: 10.1186/s13018-024-04683-2
doi:

Types de publication

Letter

Langues

eng

Sous-ensembles de citation

IM

Pagination

208

Informations de copyright

© 2024. The Author(s).

Références

Andriolo L, Candrian C, Papio T, Cavicchioli A, Perdisa F, Filardo G. Osteochondritis dissecans of the knee - conservative treatment strategies: a systematic review. Cartilage. 2019;10(3):267–77.
doi: 10.1177/1947603518758435 pubmed: 29468901
Bates JT, Jacobs JC Jr., Shea KG, Oxford JT. Emerging genetic basis of osteochondritis dissecans. Clin Sports Med. 2014;33(2):199–220.
doi: 10.1016/j.csm.2013.11.004 pubmed: 24698039 pmcid: 3976886
Bruns J, Werner M, Habermann C. Osteochondritis dissecans: etiology, Pathology, and imaging with a special focus on the knee Joint. Cartilage. 2018;9(4):346–62.
doi: 10.1177/1947603517715736 pubmed: 28639852
Chau MM, Klimstra MA, Wise KL, Ellermann JM, Tóth F, Carlson CS, et al. Osteochondritis dissecans: current understanding of Epidemiology, etiology, management, and outcomes. J Bone Joint Surg Am. 2021;103(12):1132–51.
doi: 10.2106/JBJS.20.01399 pubmed: 34109940
Dipaola JD, Nelson DW, Colville MR. Characterizing osteochondral lesions by magnetic resonance imaging. Arthroscopy. 1991;7(1):101–4.
doi: 10.1016/0749-8063(91)90087-E pubmed: 2009106
Fraissler L, Boelch SP, Schäfer T, Walcher M, Arnholdt J, Maier G, et al. Vitamin D Deficiency in patients with idiopathic and traumatic Osteochondritis dissecans of the Talus. Foot Ankle Int. 2019;40(11):1309–18.
doi: 10.1177/1071100719864325 pubmed: 31370694
Gornitzky AL, Mistovich RJ, Atuahuene B, Storey EP, Ganley TJ. Osteochondritis dissecans lesions in Family members: does a positive family history impact phenotypic potency? Clin Orthop Relat Res. 2017;475(6):1573–80.
doi: 10.1007/s11999-016-5059-x pubmed: 27600715
Heyworth BE, Kocher MS. Osteochondritis dissecans of the knee. JBJS Rev. 2015;3(7).
Hughston JC, Hergenroeder PT, Courtenay BG. Osteochondritis dissecans of the femoral condyles. J Bone Joint Surg Am. 1984;66(9):1340–8.
doi: 10.2106/00004623-198466090-00003 pubmed: 6501330
Jacobs JC Jr., Archibald-Seiffer N, Grimm NL, Carey JL, Shea KG. A review of arthroscopic classification systems for osteochondritis dissecans of the knee. Orthop Clin North Am. 2015;46(1):133–9.
doi: 10.1016/j.ocl.2014.09.009 pubmed: 25435042
Kessler JI, Nikizad H, Shea KG, Jacobs JC Jr., Bebchuk JD, Weiss JM. The demographics and epidemiology of osteochondritis dissecans of the knee in children and adolescents. Am J Sports Med. 2014;42(2):320–6.
doi: 10.1177/0363546513510390 pubmed: 24272456
Kocher MS, Tucker R, Ganley TJ, Flynn JM. Management of osteochondritis dissecans of the knee: current concepts review. Am J Sports Med. 2006;34(7):1181–91.
doi: 10.1177/0363546506290127 pubmed: 16794036
Krause M, Lehmann D, Amling M, Rolvien T, Frosch KH, Püschel K, et al. Intact bone vitality and increased accumulation of nonmineralized bone matrix in biopsy specimens of juvenile osteochondritis dissecans: a histological analysis. Am J Sports Med. 2015;43(6):1337–47.
doi: 10.1177/0363546515572579 pubmed: 25759459
Lindén B. The incidence of osteochondritis dissecans in the condyles of the femur. Acta Orthop Scand. 1976;47(6):664–7.
doi: 10.3109/17453677608988756 pubmed: 1015263
Maier GS, Lazovic D, Maus U, Roth KE, Horas K, Seeger JB. Vitamin D Deficiency: the missing etiological factor in the development of Juvenile Osteochondrosis dissecans? J Pediatr Orthop. 2019;39(1):51–4.
doi: 10.1097/BPO.0000000000000921 pubmed: 28009798
Mei-Dan O, Mann G, Steinbacher G, Cugat RB, Alvarez PD. Bilateral osteochondritis dissecans of the knees in monozygotic twins: the genetic factor and review of the etiology. Am J Orthop (Belle Mead NJ). 2009;38(9):E152–5.
pubmed: 19911106
Onoda S, Sugita T, Aizawa T, Ohnuma M, Takahashi A. Osteochondritis dissecans of the knee in identical twins: a report of two cases. J Orthop Surg (Hong Kong). 2012;20(1):108–10.
doi: 10.1177/230949901202000123 pubmed: 22535824
Skagen PS, Horn T, Kruse HA, Staergaard B, Rapport MM, Nicolaisen T. Osteochondritis dissecans (OCD), an endoplasmic reticulum storage disease? A morphological and molecular study of OCD fragments. Scand J Med Sci Sports. 2011;21(6):e17–33.
doi: 10.1111/j.1600-0838.2010.01128.x pubmed: 20561273
Stattin EL, Wiklund F, Lindblom K, Onnerfjord P, Jonsson BA, Tegner Y, et al. A missense mutation in the aggrecan C-type lectin domain disrupts extracellular matrix interactions and causes dominant familial osteochondritis dissecans. Am J Hum Genet. 2010;86(2):126–37.
doi: 10.1016/j.ajhg.2009.12.018 pubmed: 20137779 pmcid: 2820178
Stattin EL, Lindblom K, Struglics A, Önnerfjord P, Goldblatt J, Dixit A, et al. Novel missense ACAN gene variants linked to familial osteochondritis dissecans cluster in the C-terminal globular domain of aggrecan. Sci Rep. 2022;12(1):5215.
doi: 10.1038/s41598-022-09211-y pubmed: 35338222 pmcid: 8956744

Auteurs

Luca Bausch (L)

Department of Sports Orthopaedics, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany.

Monika Probst (M)

Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany.

Lorenz Fritsch (L)

Department of Sports Orthopaedics, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany.

Julian Mehl (J)

Department of Sports Orthopaedics, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany.

Sebastian Siebenlist (S)

Department of Sports Orthopaedics, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany. sebastian.siebenlist@tum.de.

Lukas Willinger (L)

Department of Sports Orthopaedics, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany.

Classifications MeSH