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October 1925


Arch Surg. 1925;11(4):633-648. doi:10.1001/archsurg.1925.01120160146010

OSTEOCHONDRITIS DISSECANS  Krida,41 reporting three cases of osteochondral fracture of the knee joint, states that the condition corresponds in some particulars to Koenig's osteochondritis dissecans. It occurs usually in young adults and is produced by a direct blow on the knee. The trauma produces an osteochondral fracture of a section of the articular portion of the internal condyle without primary displacement of the detached fragment. There are three phases: (1) when the detached fragment is still loosely attached by connective or fibrous tissue; (2) when it is detached but has not been extruded from its crater, and (3) when it is a loose body in the joint. The first phase is hard to demonstrate by roentgen-ray examination. The second is more distinct. The author feels that since diagnosis is so difficult, arthrotomy is justified to determine the exact condition, and he advises the used of the curved incision running

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