Osteochondritis dissecans of the ankle joint?a new therapy-related classification

This classification is based on the results of a retrospective study with 86 patients treated arthroscopically for osteochondritis dissecans (OD) of the ankle joint. Radiography, magnetic resonance imaging (MRI) and the findings from arthroscopy were combined for a new classification (six stages) of OD. Additionally, 17 patients of a prospective study based on preoperative and postoperative findings were used to validate this classification. The classification stages have been developed taking into account localization, extent of the necrotic area of subchondral bone and cartilage, edema or perifocal alterations, and especially the uptake of gadolinium (Magnevist, i.v.) in MRI examination. Furthermore, a therapy strategy has been suggested based on arthroscopic results, imaging modalities, and patient age.