Medial femoral condyle width and osteochondritis dissecans: cause or effect and the implications for osteochondral allograft transplantation

Introduction

Anecdotally, patients with osteochondritis dissecans (OCD) have larger medial femoral condyles widths (MFCW), making it difficult finding size-matched orthotopic condyles for osteochondral allograft transplantation.

Objectives

(1) measure MFCW and tibial plateaus width (TPW) using magnetic resonance imaging (MRI) in patients with OCD of the MFC and (2) compare MFCWs and MFCW/TPW of patients with OCD to age and sex-matched controls.

Methods

We identified 111 patients with OCD of the MFC that had MRIs available for review. 115 age-matched patients that had MRIs for conditions that did not include medial compartment pathology served as controls.  MFCW and TPW were measured on MRIs; MFCW/TPW ratio was calculated. Patients were assigned to 4 groups based on age. A student t test statistic was used to compare MFCW and MFCW/TPW between the 4 groups as well as to the age and sex matched controls.

Results

The 111 OCD patients (70 males, mean age: 25.7) had a mean MFCW of 29.3 mm.  The 115 control patients (74 men, mean age: 25.6) had a mean MFCW of 24.8 mm. Men with OCD had wider MFCs compared to women (P < .001). For both the OCD and control populations, there was no statistical significance between MFCW and age. Overall, when controlling for age and sex, OCD patients had larger MFCWs than controls (P < .001).

Conclusions

Uniform widening of the MFC in OCD patients lends evidence that a wider MFC might be causal in the development of OCD.