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Weight of the patient
5%
120/2546
Presence of open physes
80%
2032/2546
Gender
0%
12/2546
Location of the lesion within the knee
13%
332/2546
A history of trauma to the affected joint
1%
32/2546
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The radiograph is consistent with an osteochondritis dissecans (OCD) lesion in the most common location on the medial femoral condyle. The reference by Cain et al presents an overview of the treatment options available for osteochondral defects in the knee in both adolescents and adults, and proposes a treatment algorithm for both patient populations. In the adolescent with OCD the presence of adequate remaining skeletal growth (open physes) is the most important determinant of treatment. Typically, in the presence of open physes, these lesions are treated non-operativley with a 6 week trial of non-weight bearing. Indications for surgery include near growth plate completion, loose fragments, or severe symptoms that do not improve with nonoperative management. Cahill et al review conservative management of juvenile OCD, specifically focusing on the important role of compliance in successful outcomes. They define the interdependent roles of the parents, patient, and the physician, referred to as the "compliance triad". They specifically discuss how to develop compliance in the triad, the importance of early diagnosis, and the results of conservative treatment.
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