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April 29, 1961

Osteochondritis Dissecans: Loose Bodies in Joints. Etiology, Pathology, Treatment

JAMA. 1961;176(4):394. doi:10.1001/jama.1961.03040170140040

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This is an authoritative clinical monograph by the author of Injuries of the Knee Joint. The first part of the book presents the author's views concerning the cause and pathology of osteochondritis dissecans in various joints. A relationship is demonstrated between the classical lesion and various other epiphyseal conditions. The author's opinions are supported by well-correlated clinical, radiological, and operative data.

The remainder of the book is devoted to treatment. The author advocates conservative surgery. The loose fragment is nailed to the defect after suitable preparation of the bony surfaces; the nail is extracted at a second arthrotomy. Although longterm end-results are lacking, the method seems well suited for the treatment of large defects and osteochondral fractures in adults. Unfortunately, the author also unreservedly advocates the use of this method in the treatment of knee lesions in children. This is contrary to the wide experience of Green and Banks, whom

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