{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T04:50:47Z","timestamp":1791867047794,"version":"4.3.4"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,6,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Osteochondritis dissecans of the knee (KOCD) may be a source of pain in active, skeletally immature patients. An association between the condylar lesion location and lower-extremity coronal plane malalignment has been established, but clinical implications have been poorly understood. This study aimed to confirm the high rate of malalignment in KOCD and variation in demographic characteristics, presentation features, and disease severity between those with and without malalignment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Prospectively collected clinical, demographic, and radiographic data were obtained, and standard standing alignment measurements were evaluated from an institutional KOCD cohort. Alignment was defined as whether the mechanical axis passed between the condyles (neutral), the lateral femoral condyle (valgus), or the medial femoral condyle (varus). Comparative analysis was performed between KOCD lesions in each condyle presenting with or without malalignment. The Fisher exact test or chi-square test was used to analyze categorical variables, and the t test or Mann-Whitney U test was used to analyze continuous variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>This study examined 187 knees (156 patients, with a mean age of 12.9 years, 36.4% female); 66.3% had medial femoral condyle (MFC) lesions. Malalignment was found in 47.6% of all KOCD cases and 45.9% of skeletally immature cases. Twenty-nine (23.4%) of 124 MFC KOCD cases were in varus knees, and 42 (66.7%) of 63 lateral femoral condyle (LFC) KOCD cases were in valgus knees. MFC KOCD cases that presented in varus knees were more likely in Black or African American patients (p = 0.008) and had a larger lesion size, with a coronal width of 16.6 mm compared with MFC KOCD cases not in varus knees at 14.1 mm (p = 0.008). Similar differences were found in LFC KOCD cases presenting in valgus knees, which represented nearly all LFC KOCD cases in Black or African American patients (91.7%; p = 0.05) and had a larger lesion size, with a sagittal width of 20.8 mm compared with 16.4 mm for LFC KOCD cases not in valgus knees (p = 0.006).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Nearly one-half of knees with KOCD in skeletally immature patients may be in coronal malalignment and, thus, candidates for guided growth. Malalignment corresponding to the involved compartment was common and was present in two-thirds of lateral lesions. When malalignment placed the weight-bearing axis within the involved compartment, lesions were larger and more advanced. Thus, consideration should be given to addressing malalignment found during evaluations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Prognostic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.24.00220","type":"journal-article","created":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T16:36:32Z","timestamp":1743352592000},"page":"1188-1199","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Adolescents with Osteochondritis Dissecans of the Femoral Condyle Present with High Rates of Corresponding Coronal Malalignment"],"prefix":"10.2106","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2051-9892","authenticated-orcid":false,"given":"V. Claire","family":"Clark","sequence":"first","affiliation":[{"name":"Scottish Rite for Children, Frisco, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6584-1579","authenticated-orcid":false,"given":"Benjamin L.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Scottish Rite for Children, Frisco, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7392-244X","authenticated-orcid":false,"given":"Charles W.","family":"Wyatt","sequence":"additional","affiliation":[{"name":"Scottish Rite for Children, Frisco, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9722-5497","authenticated-orcid":false,"given":"Bayley N.","family":"Potter","sequence":"additional","affiliation":[{"name":"Scottish Rite for Children, Frisco, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0608-4623","authenticated-orcid":false,"given":"Philip L.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Scottish Rite for Children, Frisco, Texas"},{"name":"University of Texas Southwestern Medical Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry B.","family":"Ellis","sequence":"additional","affiliation":[{"name":"Scottish Rite for Children, Frisco, Texas"},{"name":"University of Texas Southwestern Medical Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"issue":"7","key":"bib2-20260205","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.2106\/JBJS.RVW.N.00095","article-title":"Osteochondritis dissecans of the knee","volume":"3","author":"Heyworth","year":"2015","journal-title":"JBJS Rev."},{"issue":"1","key":"bib3-20260205","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1177\/03635465211057103","article-title":"Descriptive epidemiology from the Research in Osteochondritis Dissecans of the Knee (ROCK) prospective cohort","volume":"50","author":"Nissen","year":"2022","journal-title":"Am J Sports Med."},{"issue":"2","key":"bib5-20260205","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/s12178-020-09611-5","article-title":"Management of the failed OCD","volume":"13","author":"Perkins","year":"2020","journal-title":"Curr Rev Musculoskelet Med."},{"issue":"1","key":"bib6-20260205","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1177\/03635465231211497","article-title":"Osteochondritis dissecans of the knee associated with mechanical overload","volume":"52","author":"van der Weiden","year":"2024","journal-title":"Am J Sports Med."},{"issue":"10","key":"bib7-20260205","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.1016\/j.joca.2017.07.005","article-title":"Incidence of symptomatic osteochondritis dissecans lesions of the knee: a population-based study in Olmsted County","volume":"25","author":"Pareek","year":"2017","journal-title":"Osteoarthritis Cartilage."},{"issue":"2","key":"bib8-20260205","doi-asserted-by":"crossref","first-page":"90","DOI":"10.5435\/00124635-200602000-00004","article-title":"Osteochondritis dissecans of the knee","volume":"14","author":"Crawford","year":"2006","journal-title":"J Am Acad Orthop Surg."},{"issue":"4","key":"bib9-20260205","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1177\/1947603517715736","article-title":"Osteochondritis dissecans: etiology, pathology, and imaging with a special focus on the knee joint","volume":"9","author":"Bruns","year":"2018","journal-title":"Cartilage."},{"issue":"4","key":"bib10-20260205","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1177\/0363546520905567","article-title":"Osteochondritis dissecans lesion location is highly concordant with mechanical axis deviation","volume":"48","author":"Brown","year":"2020","journal-title":"Am J Sports Med."},{"issue":"7","key":"bib11-20260205","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.1177\/0363546509359070","article-title":"Association between mechanical axis of the leg and osteochondritis dissecans of the knee: radiographic study on 103 knees","volume":"38","author":"Jacobi","year":"2010","journal-title":"Am J Sports Med."},{"issue":"4","key":"bib12-20260205","first-page":"231","article-title":"Osteochondritis dissecans: a multicenter study of the European Pediatric Orthopedic Society","volume":"8","author":"Hefti","year":"1999","journal-title":"J Pediatr Orthop B."},{"issue":"1","key":"bib13-20260205","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1302\/1863-2548-11-160173","article-title":"Femoral osteochondritis of the knee: prognostic value of the mechanical axis","volume":"11","author":"Gonzalez-Herranz","year":"2017","journal-title":"J Child Orthop."},{"issue":"4","key":"bib14-20260205","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/j.knee.2018.02.005","article-title":"Epidemiology and patient-reported outcome after juvenile osteochondritis dissecans in the knee","volume":"25","author":"Ananthaharan","year":"2018","journal-title":"Knee."},{"issue":"7","key":"bib15-20260205","doi-asserted-by":"crossref","first-page":"2325967117704644","DOI":"10.1177\/2325967117704644","article-title":"Nonoperative management of osteochondritis dissecans of the knee: progression to osteoarthritis and arthroplasty at mean 13-year follow-up","volume":"5","author":"Sanders","year":"2017","journal-title":"Orthop J Sports Med."},{"issue":"4","key":"bib16-20260205","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1007\/s11999-012-2290-y","article-title":"A review of knowledge in osteochondritis dissecans: 123 years of minimal evolution from K\u00f6nig to the ROCK study group","volume":"471","author":"Edmonds","year":"2013","journal-title":"Clin Orthop Relat Res."},{"issue":"12","key":"bib17-20260205","doi-asserted-by":"crossref","first-page":"3717","DOI":"10.1007\/s00167-014-3289-6","article-title":"Proximal tibial morphology and its correlation with osteochondritis dissecans of the knee","volume":"23","author":"Wechter","year":"2015","journal-title":"Knee Surg Sports Traumatol Arthrosc."},{"issue":"14","key":"bib19-20260205","doi-asserted-by":"crossref","first-page":"3035","DOI":"10.3390\/jcm10143035","article-title":"Coronal and transverse malalignment in pediatric patellofemoral instability","volume":"10","author":"Palmer","year":"2021","journal-title":"J Clin Med."},{"issue":"6","key":"bib20-20260205","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1302\/2058-5241.6.210015","article-title":"Radiological assessment of lower limb alignment","volume":"6","author":"Marques Lu\u00eds","year":"2021","journal-title":"EFORT Open Rev."},{"key":"bib21-20260205","first-page":"48","article-title":"Mechanical axis deviation of the lower limbs. Preoperative planning of uniapical angular deformities of the tibia or femur","volume":"280","author":"Paley","year":"1992","journal-title":"Clin Orthop Relat Res."},{"issue":"5","key":"bib22-20260205","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.2214\/ajr.170.5.9574588","article-title":"An easy linear estimation of the mechanical axis on long-leg radiographs","volume":"170","author":"Shearman","year":"1998","journal-title":"AJR Am J Roentgenol."},{"issue":"5","key":"bib23-20260205","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1177\/036354658301100509","article-title":"99m-Technetium phosphate compound joint scintigraphy in the management of juvenile osteochondritis dissecans of the femoral condyles","volume":"11","author":"Cahill","year":"1983","journal-title":"Am J Sports Med."},{"issue":"2","key":"bib24-20260205","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1177\/0363546514566600","article-title":"Research on OsteoChondritis Dissecans of the Knee (ROCK) Study Group. Novel radiographic feature classification of knee osteochondritis dissecans: a multicenter reliability study","volume":"43","author":"Wall","year":"2015","journal-title":"Am J Sports Med."},{"issue":"10","key":"bib25-20260205","doi-asserted-by":"crossref","first-page":"2421","DOI":"10.1177\/0363546513496548","article-title":"Development and validation of a pediatric sports activity rating scale: the Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS)","volume":"41","author":"Fabricant","year":"2013","journal-title":"Am J Sports Med."},{"issue":"3 Suppl","key":"bib26-20260205","article-title":"Validity, means, and distribution of the HSS Pedi-FABS in pediatric athletes and in common sports","volume":"7","author":"Wagner","year":"2019","journal-title":"Orthop J Sports Med."},{"issue":"9","key":"bib27-20260205","doi-asserted-by":"crossref","first-page":"2221","DOI":"10.1177\/0363546520930427","article-title":"Osteochondritis dissecans of the knee: an interrater reliability study of magnetic resonance imaging characteristics","volume":"48","author":"Fabricant","year":"2020","journal-title":"Am J Sports Med."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.24.00220","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:45:45Z","timestamp":1787751945000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.24.00220"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,28]]},"references-count":24,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.24.00220","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,28]]}}}