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  • 1
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    Descriptive Epidemiology From the Research in Osteochondritis Dissecans of the Knee (ROCK) Prospective Cohort
    SAGE Publications ; 2022
    In:  The American Journal of Sports Medicine Vol. 50, No. 1 ( 2022-01), p. 118-127
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 50, No. 1 ( 2022-01), p. 118-127
    Abstract: Osteochondritis dissecans (OCD) occurs most commonly in the knees of young individuals. This condition is known to cause pain and discomfort in the knee and can lead to disability and early knee osteoarthritis. The cause is not well understood, and treatment plans are not well delineated. The Research in Osteochondritis Dissecans of the Knee (ROCK) group established a multicenter, prospective cohort to better understand this disease. Purpose: To provide a baseline report of the ROCK multicenter prospective cohort and present a descriptive analysis of baseline data for patient characteristics, lesion characteristics, and clinical findings of the first 1000 cases enrolled into the prospective cohort. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Patients were recruited from centers throughout the United States. Baseline data were obtained for patient characteristics, sports participation, patient-reported measures of functional capabilities and limitations, physical examination, diagnostic imaging results, and initial treatment plan. Descriptive statistics were completed for all outcomes of interest. Results: As of November 2020, a total of 27 orthopaedic surgeons from 17 institutions had enrolled 1004 knees with OCD, representing 903 patients (68.9% males; median age, 13.1 years; range, 6.3-25.4 years), into the prospective cohort. Lesions were located on the medial femoral condyle (66.2%), lateral femoral condyle (18.1%), trochlea (9.5%), patella (6.0%), and tibial plateau (0.2%). Most cases involved multisport athletes (68.1%), with the most common primary sport being basketball for males (27.3% of cases) and soccer for females (27.6% of cases). The median Pediatric International Knee Documentation Committee (Pedi-IKCD) score was 59.9 (IQR, 45.6-73.9), and the median Pediatric Functional Activity Brief Scale (Pedi-FABS) score was 21.0 (IQR, 5.0-28.0). Initial treatments were surgical intervention (55.4%) and activity restriction (44.0%). When surgery was performed, surgeons deemed the lesion to be stable at intraoperative assessment in 48.1% of cases. Conclusion: The multicenter ROCK group has been able to enroll the largest knee OCD cohort to date. This information is being used to further understand the pathology of OCD, including its cause, associated comorbidities, and initial presentation and symptoms. The cohort having been established is now being followed longitudinally to better define and elucidate the best treatment algorithms based on these presenting signs and symptoms.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/03635465211057103
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
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  • 2
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    Complications with flexible nailing of femur fractures more than double with child obesity and weight 〉50 kg
    SAGE Publications ; 2009
    In:  Journal of Children's Orthopaedics Vol. 3, No. 1 ( 2009-02), p. 53-58
    Details
    In: Journal of Children's Orthopaedics, SAGE Publications, Vol. 3, No. 1 ( 2009-02), p. 53-58
    Abstract: Previous studies report that children above the 95th percentile in weight for their age had an increased risk for complications following titanium elastic nailing for femur fractures. The purpose of this study is to examine whether obesity, defined as body mass index (BMI) 〉 95th percentile, and/or simple weight correlates with an increased rate of complications. Methods The incidence of complications was compared between obese and non-obese patients and also between patients who weighed ≥50 kg and those 〈 50 kg. Results The overall complication rate was 23% (16/71). The complication rate was 17% (10/58) for “non-obese” patients and 46% (6/13) for “obese” patients. This difference was statistically significant ( P = 0.03). The complication rate was 46% (6/13) in children who weighed ≥50 kg and 17% (10/58) in children who weighed 〈 50 kg. This difference was also statistically significant ( P = 0.03). Conclusions This study demonstrates that obesity (BMI 〉 95th percentile) and weight over 50 kg predispose patients to increased risk of surgical complications when undergoing flexible elastic nailing for femur fractures. Both obese children and children weighing ≥50 kg were two times more likely to have a complication when undergoing this procedure.
    Type of Medium: Online Resource
    ISSN: 1863-2521 , 1863-2548
    URL: Article
    DOI: 10.1007/s11832-008-0149-2
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2009
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  • 3
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    Transarticular Versus Retroarticular Drilling of Stable Osteochondritis Dissecans of the Knee: A Prospective Multicenter Randomized Controlled Trial by the ROCK Group
    SAGE Publications ; 2023
    In:  The American Journal of Sports Medicine Vol. 51, No. 6 ( 2023-05), p. 1392-1402
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 51, No. 6 ( 2023-05), p. 1392-1402
    Abstract: When stable osteochondritis dissecans (OCD) lesions of the femoral condyle in a skeletally immature patient fail to heal with nonoperative methods, the standard of care treatment is condylar OCD drilling. Two primary OCD drilling techniques have been described, but no prospective studies have compared their relative effectiveness. Purpose/Hypothesis: The purpose of this study was to compare the healing and function after transarticular drilling (TAD) with that after retroarticular drilling (RAD). It was hypothesized that there would be no difference in rate or time to healing, rate or time to return to sports, patient-reported outcomes (PROs), or secondary OCD-related surgery. Study Design: Randomized controlled clinical trial; Level of evidence, 1. Methods: Skeletally immature patients with magnetic resonance imaging–confirmed stable OCD lesions of the medial femoral condyle who did not demonstrate substantial healing after a minimum of 3 months of nonoperative treatment were prospectively enrolled by 1 of 17 surgeon-investigators at 1 of 14 centers. Patients were randomized to the TAD or RAD group. Tourniquet time, fluoroscopy time, and complications were compared between the treatment groups. Postoperatively, serial radiographs were obtained every 6 weeks to assess healing, and PROs were obtained at 6 months, 12 months, and 24 months. Results: A total of 91 patients were included, consisting of 51 patients in the TAD and 40 patients in the RAD group, who were similar in age, sex distribution, and 2-year PRO response rate. Tourniquet time and fluoroscopy time were significantly shorter with TAD (mean, 38.1 minutes and 0.85 minutes, respectively) than RAD (mean, 48.2 minutes and 1.34 minutes respectively) ( P = .02; P = .004). In the RAD group, chondral injury from K-wire passage into the intra-articular space was reported in 9 of 40 (22%) patients, but no associated postoperative clinical sequelae were identified in these patients. No significant differences between groups were detected in follow-up Pediatric–International Knee Documentation Committee, Lysholm, Marx Activity Scale, or Knee injury and Osteoarthritis Outcome Score Quality of Life scores. Healing parameters were superior at 6 months and 12 months in the TAD group, compared with the RAD group, and secondary OCD surgery occurred in 4% of patients who underwent TAD and 10% of patients who underwent RAD ( P = .40). Patients in the TAD group returned to sports earlier than those in the RAD group ( P = .049). Conclusion: TAD showed shorter operative time and fluoroscopy time and superior healing parameters at 6 and 12 months, but no differences were seen in 24-month healing parameters or PROs at all follow-up time points, when compared with RAD. Registration: NCT01754298 (ClinicalTrials.gov identifier).
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/03635465231165290
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
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  • 4
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    CLINICAL EFFECTIVENESS OF TRANS-ARTICULAR VERSUS RETRO-ARTICULAR DRILLING OF STABLE OSTEOCHONDRITIS DISSECANS OF THE KNEE: A, PROSPECTIVE RANDOMIZED CONTROLLED TRIAL BY THE ROCK STUDY GROUP
    SAGE Publications ; 2021
    In:  Orthopaedic Journal of Sports Medicine Vol. 9, No. 7_suppl3 ( 2021-07-01), p. 2325967121S0012-
    Details
    In: Orthopaedic Journal of Sports Medicine, SAGE Publications, Vol. 9, No. 7_suppl3 ( 2021-07-01), p. 2325967121S0012-
    Abstract: The most common presentation of knee osteochondritis dissecans (OCD) is a stable lesion on the lateral aspect of the medial femoral condyle (MFC) in an adolescent or pre-adolescent athlete. Standard of care for conservative treatment, include activity modification and weight bearing protection. Failed conservative management often leads arthroscopy and drilling of the lesion. Two different primary drilling techniques have been utilized, but no prospective studies have compared their relative effectiveness. Hypothesis/Purpose: The study hypothesis was that trans-articular (TAD) and retro-articular drilling (RAD) would demonstrate similar rates of healing, times to return to sports, and patient-reported outcome scores (PROs). Methods: Skeletally immature (n=113) patients presenting with radiograph indicated stable OCD of the MFC who did not demonstrate healing despite a minimum of 3 months of non-operative treatment were prospectively enrolled and randomized to TAD or RAD, for which 17 surgeon-investigators (at 14 centers, representing all major regions in the U.S.). Serial radiographs were obtained every 6 weeks to assess healing, and PROs were obtained at 6 months, 12 months, and 24 months. Twelve patients were due to lesion instability detected at the time of surgery, Results: Ninety-one study subjects were included, consisting of 51 TAD and 40 RAD patients, with the two groups being of similar age (12.6 years vs. 11.9 years), sex distribution (45% vs. 27% female, p=0.081), and 2-year PRO response rate (both 90%). No significant difference between TAD and RAD was detected in follow-up Pedi-IKDC, Lysholm, Marx knee activity score, or KOOS QOL scores (Table 1). Revision/additional OCD surgery occurred in 10% of patients in RAD and 4% in TAD. 71% of TAD patients reached a ‘healed’ status at a mean of 1.15 years, compared with 58% RAD patients at a mean of 1.06 years. Conclusion: While both primary forms of OCD drilling (TAD and RAD) showed consistent post-operative healing, achieving a completely ‘healed’ status was often a more prolonged process, taking approximately 1 year, despite clinical improvement being achieved much sooner. While PROs were similar between drilling techniques, revision surgery rates were more than twice as common with RAD compared with TAD but the overall risk was low and the Absolute Risk was only 6%. [Table: see text]
    Type of Medium: Online Resource
    ISSN: 2325-9671 , 2325-9671
    URL: Article
    DOI: 10.1177/2325967121S00129
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
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  • 5
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    A new surgical technique for the treatment of supracondylar humerus fracture malunions in children
    SAGE Publications ; 2011
    In:  Journal of Children's Orthopaedics Vol. 5, No. 4 ( 2011-08), p. 305-312
    Details
    In: Journal of Children's Orthopaedics, SAGE Publications, Vol. 5, No. 4 ( 2011-08), p. 305-312
    Abstract: To report a new locking lateral closing wedge osteotomy used in repairing pediatric supracondylar humerus fracture malunions, which allows for coronal and sagittal plane correction of both cubitus varus and extension. Methods At our institution, eight children with cubitus varus resulting from prior supracondylar humerus fracture malunions underwent a new technique of lateral closing wedge osteotomy performed by a single surgeon. Preoperative templating created from radiographs of the bilateral upper extremities were compared with clinical exam to determine the angle of triangular bone that must be removed in order to correct the varus and any extension deformity. A lateral approach and subperiosteal dissection exposed the distal humerus. A transverse osteotomy created a proximal and distal fragment, from which two triangles of bone were removed. The fragments were reunited, parallel lateral pins were placed, and live imaging confirmed stable fixation. Results The osteotomy was performed in eight patients, with an average age of 6.3 years. The mean interval between the initial injury and corrective osteotomy was 2.4 years. All patients ended up with flexion of 130° or greater with full and symmetrical pronation and supination. The average ulnohumeral angular correction was 25.5°, which was within 2° of the uninvolved elbow in seven patients and to within 5° in one patient. Baumann's angle averaged 85.3° preoperatively and 73.7° postoperatively, with an average 70.2° in the uninvolved elbow. All of the patients healed with excellent clinical and radiographic alignment and complete function. There were no complications or revisions. Conclusion Varus malunion is a well-described complication of pediatric supracondylar humerus fracture repairs, and many different osteotomy techniques have been described. This series demonstrates that an interlocking lateral wedge osteotomy with parallel lateral pin fixation can provide reliable correction of varus and extension deformity, with a minimal complication rate.
    Type of Medium: Online Resource
    ISSN: 1863-2521 , 1863-2548
    URL: Article
    DOI: 10.1007/s11832-011-0349-z
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2011
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  • 6
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    Diabetes-Related Quality of Life: Learning From Individuals Making Lifestyle Changes to Improve Type 2 Diabetes Control
    SAGE Publications ; 2023
    In:  The Science of Diabetes Self-Management and Care Vol. 49, No. 2 ( 2023-04), p. 136-149
    Details
    In: The Science of Diabetes Self-Management and Care, SAGE Publications, Vol. 49, No. 2 ( 2023-04), p. 136-149
    Abstract: The purpose of this study was to explore how treatment adherence and lifestyle changes required for glycemic control in type 2 diabetes (T2D) are related to quality of life (QoL) among predominantly ethnic minority and socioeconomically disadvantaged adults engaged in making changes to improve T2D self-management. Methods: Adults with T2D in New York City were recruited for the parent study based on recent A1C (≥7.5%) and randomly assigned to 1 of 2 arms, receiving educational materials and additional self-management support calls, respectively. Substudy participants were recruited from both arms after study completion. Participants (N = 50; 62% Spanish speaking) were interviewed by phone using a semistructured guide and were asked to define QoL and share ways that T2D, treatment, self-management, and study participation influenced their QoL. Interviews were analyzed using thematic analysis. Results: QoL was described as a multidimensional health-related construct with detracting and enhancing factors related to T2D. Detracting factors included financial strain, symptom progression and burden, perceived necessity to change cultural and lifestyle traditions, and dietary and medical limitations. Enhancing factors included social support, diabetes education, health behavior change, sociocultural connection. Conclusion: QoL for diverse and socioeconomically disadvantaged adults with T2D is multifaceted and includes aspects of health, independence, social support, culture, and lifestyle, which may not be captured by existing QoL measures. Findings may inform the development of a novel QoL measure for T2D.
    Type of Medium: Online Resource
    ISSN: 2635-0106 , 2635-0114
    URL: Article
    DOI: 10.1177/26350106221149665
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
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  • 7
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    Demographics and Epidemiology of Discoid Menisci of the Knee: Analysis of a Large Regional Insurance Database
    SAGE Publications ; 2020
    In:  Orthopaedic Journal of Sports Medicine Vol. 8, No. 9 ( 2020-09-01), p. 232596712095066-
    Details
    In: Orthopaedic Journal of Sports Medicine, SAGE Publications, Vol. 8, No. 9 ( 2020-09-01), p. 232596712095066-
    Abstract: A discoid meniscus is a morphological variant of normal knee joint meniscus shape and ultrastructure that can lead to traumatic tearing of this tissue and early joint osteoarthritis. Purpose/Hypothesis: The purpose of this study was to determine the prevalence of discoid menisci in a large, ethnically diverse regional cohort and to evaluate possible risk factors. The hypothesis was that there would be no difference in the epidemiological distribution of discoid menisci based on ethnicity or sex. Study Design: Descriptive epidemiology study. Methods: The study population was from a regional, integrated health care system cohort from Kaiser Permanente of Southern California that, as of 2016, included more than 4.5 million patients. Patient demographics included age, sex, and ethnicity within this cohort. Potential risk factors analyzed included age, sex, ethnicity, and body mass index (BMI). Unique characteristics of a discoid meniscus were analyzed, including a symptomatic versus asymptomatic meniscus, location of meniscal tear and type of meniscus, and frequency of meniscal surgical treatment. Results: A total of 223 patients with a confirmed discoid meniscus were identified, yielding an overall prevalence rate of 4.88 per 100,000 patients. Those identifying as Black had the lowest prevalence (2.68/100,000), while Hispanic ethnicity had the highest (6.01/100,000). However, there was no significant difference with regard to ethnicity ( P = .283), nor any significant difference between sexes. BMI did not significantly influence the rate of discoid menisci ( P = .504). A majority (77.5%) of patients were symptomatic, while 22.5% of patients with discoid menisci were asymptomatic and discovered incidentally. Symptomatic discoid menisci were more likely to be operated on compared with asymptomatic discoid menisci (71% vs 14%, respectively; P = .001; odds ratio, 14.8 [95% CI, 5.8-37.2]). Horizontal and bucket-handle tears were the more common tear types. Of the discoid menisci in this cohort, 55.6% underwent surgery, with 95.2% undergoing reported saucerization. Conclusion: In this very diverse population-based cohort of patients, there did not seem to be a significant predilection of discoid menisci with regard to ethnicity. Neither sex nor BMI significantly influenced the rate of discoid menisci. More than three-quarters of those with a diagnosed discoid meniscus were symptomatic. Of the tears that occurred with discoid menisci, horizontal and bucket-handle tears made up the largest proportion.
    Type of Medium: Online Resource
    ISSN: 2325-9671 , 2325-9671
    URL: Article
    DOI: 10.1177/2325967120950669
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
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  • 8
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    The Incidence of Surgery in Osteochondritis Dissecans in Children and Adolescents
    SAGE Publications ; 2016
    In:  Orthopaedic Journal of Sports Medicine Vol. 4, No. 3 ( 2016-03-01), p. 232596711663551-
    Details
    In: Orthopaedic Journal of Sports Medicine, SAGE Publications, Vol. 4, No. 3 ( 2016-03-01), p. 232596711663551-
    Abstract: The frequency of osteochondritis dissecans (OCD), a disorder of the subchondral bone and articular cartilage, is not well described. Purpose: To assess the frequency of pediatric OCD lesions that progress to surgery based on sex, joint involvement, and age. Study Design: Descriptive epidemiology study. Methods: A retrospective chart review (2007-2011) was performed on OCD. Inclusion criteria included OCD of any joint and patients aged 2 to 19 years. Exclusion criteria included traumatic osteochondral fractures or coexistence of non-OCD intra-articular lesions. Differences in progression toward surgery were compared between age groups, sex, and joint location. Logistical regression analysis was performed by sex, age, and ethnicity. Results: Overall, 317 patients with a total of 334 OCD lesions were found. The majority of lesions (61.7%) were in the knee, with ankle, elbow, shoulder, and foot lesions representing 25.4%, 12.0%, 0.6%, and 0.3% of all lesions, respectively. The majority of joints needing surgery were in the knee (58.5%), with ankle and elbow lesions representing 22.9% and 18.6% of surgeries performed, respectively. The percentage of all OCD lesions progressing to surgery was 35.3%; surgical progression for knee, ankle, and elbow joints was 33.5%, 31.8%, and 55.0%, respectively. Logistic regression analysis found no statistically significant different risk of progressing to surgery for OCD of the knee, elbow, and ankle between sexes. Patients aged 12 to 19 years had a 7.4-times greater risk of progression to surgery for knee OCD lesions than 6- to 11-year-olds. Patients aged 12 to 19 years were 8.2 times more likely to progress to surgery for all OCD lesions than patients aged 6 to 11 years. Progression to surgery of ankle OCD did not significantly differ based on location. Three of 4 trochlear lesions progressed to surgery, along with 1 of 1 tibial, 1 of 3 patellar, 40.3% of lateral femoral condylar, and 28.2% of medial femoral condylar lesions. Conclusion: In this large cohort study of pediatric OCD patients, 35% progressed to surgery. Progression to surgery did not differ significantly between sexes with OCD of any joint. Progression to surgery for OCD of the knee, elbow, and ankle strongly correlated with patient age at the time of diagnosis. Clinical Relevance: The knowledge of likelihood of progression to surgery of OCD by location, sex, and age is useful in counseling patients and in planning treatment. This study confirms a worse prognosis in the nonoperative treatment of older patients with OCD.
    Type of Medium: Online Resource
    ISSN: 2325-9671 , 2325-9671
    URL: Article
    DOI: 10.1177/2325967116635515
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
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  • 9
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    Cell Saver: Is it beneficial in scoliosis surgery?
    SAGE Publications ; 2007
    In:  Journal of Children's Orthopaedics Vol. 1, No. 4 ( 2007-10), p. 221-227
    Details
    In: Journal of Children's Orthopaedics, SAGE Publications, Vol. 1, No. 4 ( 2007-10), p. 221-227
    Abstract: Review of the use of Cell Saver in a non-randomized group of patients undergoing spinal fusion for scoliosis. Objectives To determine the efficacy of the use of Cell Saver for spinal fusions for scoliosis. Summary of background data Although Cell Saver is widely used in scoliosis surgery, it is not clear whether its use decreases the need for other transfusions or whether there are certain patients more likely to benefit from its use. The blood collected by Cell Saver intraoperatively is not always of sufficient volume to be returned to the patient, and there are no current guidelines addressing the amount that is likely to be returned to the patient. Purpose The purpose of this study was to determine: Does use of Cell Saver reduce the need for other transfusions in scoliosis surgery? Is there an amount of blood loss at which Cell Saver is likely to be returned? Materials and methods The study group consisted of 95 children who had undergone posterior spinal fusion between January 2002 and March 2004 with one of two surgeons. One surgeon used Cell Saver, the other surgeon did not. Of the total, 58 patients who underwent posterior spinal fusion with the use of Cell Saver (group 1) were compared with the 37 (group 2) who underwent the same procedure without the use of Cell Saver. Results Of those in group 1, 34 received Cell Saver blood back as an intraoperative autologous transfusion (IAT) (59%). Patients in the Cell Saver group were just as likely to receive non-Cell Saver transfusions as those in the control group ( P = 0.12). Of the 39 patients who lost more than 500 cc of blood, 34 received IAT (87%). No patient who lost less than 500 cc of blood received IAT. Conclusion The use of Cell Saver does not reduce the need for other transfusions in scoliosis surgery. The amount of blood loss at which Cell Saver is likely to be returned is 500 cc. We demonstrated no benefit in the use of Cell Saver in our patient population.
    Type of Medium: Online Resource
    ISSN: 1863-2521 , 1863-2548
    URL: Article
    DOI: 10.1007/s11832-007-0032-6
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2007
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  • 10
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    Incidence of Osteochondritis Dissecans in Adults
    SAGE Publications ; 2018
    In:  The American Journal of Sports Medicine Vol. 46, No. 7 ( 2018-06), p. 1592-1595
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 46, No. 7 ( 2018-06), p. 1592-1595
    Abstract: Osteochondritis dissecans (OCD) has frequently been described in children and adolescents, but cases of OCD in adults are certainly encountered. Little has been published on the epidemiology of OCD in adult patients. Purpose: To assess the frequency of OCD lesions in adults and assess the risk by age, sex, and ethnicity. Study Design: Descriptive epidemiology study. Methods: The authors assessed all patients aged 20 to 45 years from the entire database of patients enrolled as members of Kaiser Permanente Southern California from January 2011 until December 2013. Kaiser Southern California is an integrated health care system serving a racially, ethnically, and socioeconomically diverse population of 〉 3.5 million patients. A retrospective chart review was done on OCD during this period. Inclusion criteria included OCD of any joint. Exclusion criteria included traumatic osteochondral fractures and coexistence of intra-articular lesions other than OCD. Joint involvement/location, laterality, and all patient demographics were recorded. Results: Among 122 patients, a total of 124 OCD lesions were found. The majority of lesions were in the ankle (n = 76) and knee (n = 43), with 3 foot lesions and 2 elbow lesions identified. OCD lesions were identified in 75 men (62%) and 47 women (38%). Overall incidence rates per 100,000 person-years were 3.42 for all OCD, 2.08 for ankle OCD, and 1.21 for knee OCD. The relative risk of adult OCD for men was twice that of women. The relative risk of adult OCD for white patients was 2.3 that of Asians and 1.7 that of Hispanics. Risk of knee OCD was 3.6 times higher for men than women. As compared with women, men had a higher risk for lateral femoral condyle OCD lesions versus the medial femoral condyle ( P = .05; odds ratio [OR], 5.19). Conclusion: This large cohort study of Southern California adults with OCD demonstrated an increased OR for men (vs women) of OCD in all joints. The majority of symptomatic lesions were present in the ankle rather than the knee, as previously found in children. White and black patients had the highest OR of OCD; men had a significantly greater OR of lateral femoral condyle knee lesions as compared with women.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546518764676
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 2063945-4
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