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The association between later cortical potentials and later phases of postural reactions evoked by perturbations to upright stance.

Previous studies have suggested that early cortical potentials (e.g. N1) that are evoked by perturbations to upright stance are associated with sensory processing of the initial perturbation and that later potentials may represent cognitive processing of this perturbation. However, it has also been suggested that later cortical potentials could reflect sensory and motor processing of later phases of the postural reaction. The current study set out to provide additional insight into the association between perturbation-evoked cortical potentials and postural reactions evoked by whole-body perturbations. By altering the deceleration onset of the perturbation, which altered the timing of later postural responses, we determined whether changes in later postural responses were associated with changes in later potentials. Based on previous work, we hypothesized that later potentials would not be associated with changes in later postural responses. During stance, seven healthy young adults were instructed to maintain their balance following two types of perturbations: (1) acceleration phase immediately followed by a deceleration phase (TASK 1), and (2) acceleration phase followed by a delayed deceleration phase (TASK 2). In spite of profound task differences in later postural responses, results revealed no significant differences in later potentials. This work provides additional support for the idea that latter elements of perturbation-evoked cortical responses are likely independent of evoked motor reactions required to maintain stability.

Adult↗

Lateral border zone: quantitation of lateral extension of subendocardial infarction in the dog.

This study was undertaken to quantitate the lateral extension that occurs concomitantly with the transmural extension of a subendocardial infarction. A subendocardial infarct was produced in 12 dogs by a 40 minute temporary coronary artery occlusion. Infarct extension was induced 7 days later by permanent occlusion of the same vessel. Regional myocardial blood flows confirmed that ischemia had been produced with both coronary artery occlusions. The vascular boundaries between the normally perfused and ischemic beds were defined by perfusion with different-colored Microfil solutions. The extent of subendocardial infarction and subsequent transmural and lateral extensions were assessed by point counting of histologic specimens. The initial temporary occlusion produced a 30.0 +/- 4.2% transmural infarct and the subsequent permanent occlusion a 29.2 +/- 3.5% transmural extension in a risk region of 39 +/- 4 g. Lateral extension was not measured in four dogs because the initial subendocardial infarct was patchy with markedly irregular lateral borders. In eight dogs the size of the measured lateral infarct extension from each lateral margin from two histologic sections was 0.63 +/- 0.013 cm2. The area of both lateral extensions was 1.7 +/- 0.1% of the cross-sectional area of its risk region as determined by planimetry. Using a model of the risk region, the mass of the lateral extension was estimated to be 1.4 +/- 0.3 g or 3.5 +/- 0.6% of the region at risk. Thus, at the lateral margin of a subendocardial infarct there is a border zone that is small relative to the size of the region at risk and infarcted myocardium.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Strabismus after balanced medial plus lateral wall versus lateral wall only orbital decompression for dysthyroid orbitopathy.

PURPOSE: This study aimed to determine the relative incidence and time course of new-onset strabismus after balanced medial plus lateral wall orbital decompression versus decompression of the lateral wall alone for dysthyroid orbitopathy. METHODS: The study design was a retrospective nonrandomized comparative case series. Thirty-two consecutive patients underwent balanced medial plus lateral wall orbital decompression or lateral wall orbital decompression for dysthyroid orbitopathy. The incidence, duration, and treatment of postoperative strabismus was recorded for each patient. RESULTS: Significant preoperative strabismus was present in 31% (4/13 patients) of the balanced decompression group and in 26% (5/19 patients) of the lateral wall decompression group. Only 25% (1/4) of cases of preexisting strabismus in the balanced decompression group resolved postoperatively without muscle surgery, whereas 60% (3/5) of cases in the lateral wall decompression group resolved postoperatively without surgery. Preoperative strabismus was absent in 69% (9/13) of patients in the balanced decompression group and in 74% (14/19) of patients in the lateral wall decompression group. New-onset, persistent postoperative strabismus developed in 33% (3/9) of patients in the balanced decompression group and in 7% (1/14) of patients in the lateral wall decompression group. CONCLUSION: Lateral wall orbital decompression may produce less new-onset, persistent postoperative strabismus than balanced medial plus lateral wall orbital decompression for dysthyroid orbitopathy.

Adult↗

Quantitative morphology of the lateral ligaments of the spine. Assessment of their importance in maintaining lateral stability.

STUDY DESIGN: This study used human cadaveric material to examine the three-dimensional morphology and biomechanics of the superior and lateral costotransverse ligaments and the intertransverse ligament of the spine. OBJECTIVES: To provide descriptive and quantitative data on the morphology of the lateral ligaments of the spine and to assess their importance in maintaining lateral stability, especially regarding the pathogenesis of idiopathic scoliosis. SUMMARY OF BACKGROUND DATA: Ligaments have been reported as being able to stabilize the spine by mechanical constraint and by neurologic feed-back. Midline spinal ligaments have been well studied but do not appear to be effective in maintaining lateral stability because of their sites of attachment. Lateral ligaments of the spine have not been adequately documented in the literature. METHODS: The morphology, sites of attachment, and dimensions of the superior costotransverse ligament, lateral costotransverse ligament, and intertransverse ligament from thoracic level 7 to thoracic level 10 were determined on 32 human cadavers. RESULTS: The intertransverse ligament was found not to be a true ligament. The lateral costotransverse ligament was a true ligament but did not have the characteristics appropriate for involvement in lateral stability. The superior costotransverse ligament also was a true ligament and had all of the characteristics appropriate for involvement in the active lateral balancing of the spine. CONCLUSIONS: In contrast to the midline ligaments of the spine, the superior costotransverse ligament perhaps is the most important ligament for active lateral balancing of the spine and warrants further study, particularly regarding the development of idiopathic scoliosis.

Aged↗

Single-unit study of lateral line cells in the optic tectum of Xenopus laevis: evidence for bimodal lateral line/optic units.

Responses of single units in the Xenopus tectum to stimulation of the contralateral anterior lateral line nerve (cALLN) and optic nerve were studied. Cells responded to cALLN stimulation with a phasic burst of spikes that was repeatable between trials; latencies ranged from 4 to 23 msec. The most excitable cells were located in layer 6 of the ventrolateral tectum. Cells responding to stimulation of the ipsilateral ALLN were far less numerous and robust, and showed latencies 3-10 msec greater than those of contralateral responses. Tectal cell responses to cALLN nerve stimulation grew progressively to saturation with stimulus voltage and paralleled the growth of the ALLN compound action potential; cells responded to stimulation of either supra- or infraorbital branches of cALLN. These observations indicate convergence of primary lateral line afferents in the medulla and/or tectum. Lateral line tectal cells showed strong habituation at interstimulus times less than 8-20 seconds. Experiments on bimodal cells revealed facilitatory and inhibitory interactions between optic and lateral line inputs. Some cells responded to stimulation of either lateral line or optic nerves, with combined stimulation producing responses exceeding the sum of responses to separate nerve stimulation. In other cells the response to optic nerve stimulation was markedly increased by lateral line nerve stimulation, despite the absence of response to lateral line nerve stimulation alone. Facilitation was also evident in cells that responded only to combined stimulation of lateral line and optic nerves. Some cells exhibited an early (5-10 msec) and late (20-40 msec) response to optic nerve stimulation; lateral line nerve stimulation, despite eliciting no response itself, produced strong facilitation of the early but almost complete suppression of the late optic nerve response.

Action Potentials↗

Lateral spine dual-energy X-ray absorptiometry bone mineral measurement with fan-beam design: effect of osteophytic calcifications on lateral and anteroposterior spine BMD.

Recently, fan beam (FB) designs have been made available by several manufacturers (Aloka, Hologic Lunar and Sophar) to measure lumbar spine bone mineral area density (BMD) in both an anteroposterior (AP) and a lateral projection. The present study was performed to evaluate some characteristics of a new dual energy X-ray absorptiometry (DXA) system for supine lateral scans in normals and to study possible advantages for patients with osteophytic calcifications (OC). The precision errors of in vitro and in vivo measurements were estimated by an anthropomorphic phantom and in healthy volunteers. To study the effect of osteoarthritic changes on AP and lateral DXA measurements, BMC (bone mineral content) and BMD were measured in age-matched women (n = 150) with and without OC. Precision errors for lateral BMD in vitro over 1 and 6 months were 0.58/0.67% (slow/fast scan modes) and 0.67/0.77% (slow/fast scan modes), respectively. The short- and mid-term reproducibility of BMD values were 2% and 3.5%, respectively, using the compare function (3.5% and 7.5%, respectively, without the compare facility). The analysis of women with and without OC (n = 150) demonstrated higher mean values for AP BMD (0.892 +/- 0.145 g/cm2) in patients with OC (n = 75) than in normals (0.836 +/- 0.135 g/cm2, n = 75, difference 6.3%). For lateral scans, BMD differed to a minor degree (3.1%) in patients with OC (0.629 +/- 0.133 g/cm2) compared with normals (0.610 +/- 0.117 g/cm2). Corresponding results were obtained in fast FB mode. Furthermore, we found significant (P < 0.0001) correlations between BMD in lateral and AP scans in patients without OC (r = 0.63) and in patients with OC (r = 0.57). Although the FB design facilitated fast AP and lateral scans, the higher precision errors of lateral scans could limit its application in longitudinal studies. The use of compare function should be recommended. However, BMD of lateral scans was less influenced by OC.

Absorptiometry, Photon↗

Anatomic and radioanatomic study of the lateral genicular arteries: application to prevention of postoperative hemarthrosis after arthroscopic lateral retinacular release.

Arthroscopic lateral retinacular release can be complicated by hemarthrosis in 10 to 18% of cases. The vascular structures involved are the lateral vascular pedicles of the knee. This study examines the topography of these pedicles. Anatomic and radioanatomic studies carried out in 50 specimens defined the route of the vascular pedicles at the lateral aspect of the knee. From the measurements carried out, we noted the relative homogeneity of the routes taken by the different proximo-lateral vascular pedicles, which are highly vulnerable, and the variability of the disto-lateral arterial routes. A tracing-paper study identified two distinct routes for the disto-lateral vascular pedicle and evaluated the risk of injury to it in surgical approaches to the lateral aspect of the knee. Finally, the topographic data of the study suggest the possibility of preventive hemostasis of the proximo-lateral pedicle via a minimal approach close to the patella. Furthermore, it seems possible to avoid cutting the disto-lateral pedicle if it is localised by cutaneous trans-illumination at the beginning of the operation.

Arthroscopy↗

The visual cortex of the opossum: the retrograde transport of horseradish peroxidase to the lateral geniculate and lateral posterior nuclei.

The visual cortex of opossum was studied by injecting horseradish peroxidase into the cortex and identifying labeled neurons in the thalamus. The results show that the lateral geniculate nucleus projects to area 17 in a topographical manner: the rostral lateral geniculate is represented in caudal striate cortex, and the dorsal extremity of the lateral geniculate, which probably corresponds to the zero vertical meridian, is represented along the border of area 18. Small injections in area 17 produced restricted bands of labeled neurons across the medial-lateral extent of the lateral geniculate, suggesting a greater precision in the topography than previously shown by retrograde degeneration studies. Following injections into area 17, labeled cells were also found in the lateral posterior nucleus. Injections of peristriate cortex produced labeled cells in the lateral posterior nucleus, as well as the lateral intermediate, posterior and intralaminar nuclei. Since the lateral posterior nucleus receives visual projections from the superior colliculus, the results show two visual pathways: the geniculo-striate path projecting just to core area or area 17, and a more diffuse parallel path that projects to both the core and belt. Whether or not this overlap is characteristics of the mammalian prototype it seems to be present in widely separated species.

Animals↗

Differences in amphetamine and morphine sensitivity in lateralized and non-lateralized rats: locomotor activity and drug self-administration.

Morphine and d-amphetamine were tested for their effects on locomotor activity and for their propensities to be intravenously self-administered in rats that had been screened for their tendencies to rotate (turn in circles) spontaneously at night; noctural rotation was used as a behavioral index of asymmetry in the dopaminergic nigrostriatal system. Lateralized (rotating) rats were more sensitive to the locomotor stimulant effects of d-amphetamine than non-lateralized (non-rotating) rats. The stimulant effects of low doses of morphine were also greater in lateralized rats, whereas the depressant effects of high doses of morphine were greater in non-lateralized rats. Lateralized rats self-administered more d-amphetamine than non-lateralized rats whereas non-lateralized rats self-administered more morphine than lateralized rats. The data indicate that the degree of lateralization in some brain pathways is a source of interindividual variation in drug sensitivity--this may in part be responsible for the individual tendencies of humans to selectively abuse particular types of drugs.

Amphetamine↗

Reproducibility of lateral excursive tooth contact in a semi-adjustable articulator depending on the type of lateral guidance.

The purposes of this study were (i) to compare the reproducibility of lateral tooth contacts of casts mounted in a semi-adjustable articulator when condylar guidance was set by different methods and (ii) to assess the margin of error of the variations of condylar guidance without changing lateral tooth contacts, depending on the type of lateral guidance. In subjects with different types of lateral guidance, intraoral lateral tooth contacts identified with occlusal registration strips were compared with those identified by use of a semi-adjustable articulator, setting the condylar guidance in four different ways: using protrusive wax wafers, by axiography and by adding and subtracting 5 degrees from the value of condylar guidance obtained by protrusive wax wafers. Tolerance to variations of condylar guidance without changing lateral tooth contacts was determined by increasing and decreasing the value of condylar guidance until lateral tooth contacts changed. Different ways of setting condylar guidance on a semi-adjustable articulator give rise to different values of condylar guidance in the same subject. The occlusal repercussions of these variations of condylar guidance values depend on the type of lateral guidance. Canine protection had the greatest tolerance to variations in the setting of condylar guidance without changing lateral occlusal contacts.

Adolescent↗

Development of the rat thalamus: VI. The posterior lobule of the thalamic neuroepithelium and the time and site of origin and settling pattern of neurons of the lateral geniculate and lateral posterior nuclei.

Short-survival, sequential, and long-survival thymidine radiograms of rat embryos, fetuses, and young pups were analyzed in order to determine the time of origin, site of origin, migratory route, and settling pattern of neurons of the dorsal lateral geniculate (LGD), ventral lateral geniculate (LGV), and lateral posterior (LP) nuclei of the thalamus. Quantitative examination of long-survival radiograms established that the neurons of the LGD are produced on days E14 and E15. Within the LGD there is an external-to-internal neurogenetic gradient; the majority (77%) of neurons of the external half are generated on day E14, while in the internal half the majority (64%) of neurons originate on day E15. The late-generated LGD neurons are located in the termination field of the uncrossed fibers of the optic tract. Examination of short-survival radiograms indicated that the neurons of the LGD originate in a discrete neuroepithelial eversion situated ventral to the pineal rudiment and dorsal to the putative neuroepithelium of the ventral nuclear complex. In sequential radiograms from rats injected with 3H-thymidine on day E15 and killed on days E16 and E17, the migration of young LGD neurons was followed in a posterolateral direction to the formative lateral geniculate body. By day E17, the day when the optic tract fibers begin to disperse over the lateral surface of the posterior diencephalon, the distribution of early and late-generated neurons of the LGD resembles that seen in young pups. As a whole, the neurons of the LGV are produced earlier than the neurons of the LGD. The bulk of LGV neurons are generated on days E14 and E15 in a caudal-to-rostral intranuclear neurogenetic gradient. Caudal LGV neurons are generated mainly on day E14 (82%), while a substantial proportion of rostral neurons (32%) are generated on day E15. Examination of short-survival and sequential radiograms suggest that the LGV neurons originate in an inverted sublobule situated beneath the putative neuroepithelium of the LGD. At anterior levels the putative inverted sublobule of the LGV merges imperceptibly with the neuroepithelium that produces the neurons of the lateral habenular nucleus. Like the neurons of the LGD and LGV, so also those of the LP are generated on days E14 and E15, but the neurogenetic gradients are different. There is a lateral-to-medial gradient within the LP as a whole. Peak production of neurons is on day E14 laterally (58%) and on day E15 medially (59%).(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

Comparison of medial-to-lateral versus traditional lateral-to-medial laparoscopic dissection sequences for resection of rectosigmoid cancers: randomized controlled clinical trial.

This study aimed to compare medial-to-lateral versus lateral-to-medial laparoscopic dissection sequences for resecting rectosigmoid cancers. We hypothesized that the medial-to-lateral approach was a more efficient procedure and with potentially better oncologic results. Between January 1997 and June 1999, a total of 67 patients of rectosigmoid cancer treated by one surgeon using the laparoscopic approach were recruited for this prospective, randomized, double-blind clinical trial. Using the blocked randomization method, 36 patients were allocated to a medial-to-lateral (M) group and the other 31 to a lateral-to-medial (L) group; the groups were well matched in age, gender, symptoms, body mass index, American Society of Anesthesiology (ASA) class, tumor location, tumor distance above the anal verge, tumor gross morphology, TNM stage of the tumor, and accuracy of preoperative TNM staging (p > 0.05). All patients were followed up until June 2001. We found that the M group had a significantly shorter operating time and lower overall costs than the L group (p < 0.05). There was no significant difference between these two groups in terms of intraoperative complications, conversion rate, postoperative ileus, hospitalization, postoperative pain, postoperative complications, wound length, or disability (p > 0.05). The postoperative proinflammatory response, evaluated by the C-reactive protein level and the erythrocyte sedimentation rate, was significantly lower in the M group (p < 0.05). There was no significant difference between these two groups regarding postoperative immunosuppression, as evaluated by the alterations of total lymphocyte counts and the CD4(+)/CD8(+) ratio (p > 0.05). The extent of dissection of these two dissection approaches was similar, as the harvested lymph nodes were equivalent (p > 0.05). During the whole follow-up period (median 32 months, range 24-54 months), the tumor recurrence rate was similar for these two groups of patients (5.6% in the M group vs. 6.5% in the L group; p > 0.05). These findings indicated that the medial-to-lateral approach was quicker, less expensive and possibly less invasive; moreover, it gave oncologic results similar to those achieved with the traditional lateral-to-medial dissection sequence. We thus concluded that the medial-to-lateral dissection sequence may currently be the most appropriate procedure for laparoscopic resection of rectosigmoid cancers.

Aged↗

An electrophysiological study of convergence of entopeduncular and lateral preoptic inputs on lateral habenular neurons projecting to the midbrain.

Extracellular recordings were made from single neurons in the lateral habenular nucleus of urethane-anesthetized rats. Single pulse stimulation of the entopeduncular nucleus influenced the spontaneous activity of 200 out of 293 (68%) lateral habenular neurons tested, with the most frequent response being suppression of activity and initial activation followed by suppression. Single pulse stimulation of the lateral preoptic area influenced the activity of 140 out of 165 (85%) lateral habenular neurons tested. Response were similar to those for entopeduncular stimulation. In a series of 137 lateral habenular units, 85 (62%) were influenced by stimulation of both sites indicating convergence of inputs from these two forebrain areas. Approximately half of the lateral habenular neurons which received converging inputs from entopeduncular nucleus and lateral preoptic area were activated antidromically by stimulation of the fasciculus retroflexus, indicating that they were output neurons. These electrophysiological findings support the suggestion from recent neuroanatomical studies that the lateral habenular nucleus is a site of integration for entopeduncular and limbic inputs and in turn sends signals to the midbrain.

Afferent Pathways↗

Connections to the lateral posterior-pulvinar thalamic complex from the reticular and ventral lateral geniculate thalamic nuclei: a topographical study in the cat.

The projections from the reticular thalamic nucleus and the ventral lateral geniculate nucleus to the lateral posterior-pulvinar thalamic complex were studied in the adult cat using the retrograde transport of horseradish peroxidase. Small, stereotaxically guided injections of the enzyme were placed in the various nuclei of this complex, including the pulvinar, lateralis intermedius oralis, lateralis intermedius caudalis, lateralis posterior lateralis, lateralis posterior medialis and lateralis medialis nuclei. The distribution of labeled neurons indicates that these nuclei receive topographically organized projections from the reticular and ventral lateral geniculate nuclei. The pulvinar nucleus receives only very scarce projections from the reticular thalamic nucleus originating in its posterodorsal and posteroventral sectors. The reticular projection to the nucleus lateralis intermedius oralis is even sparser. The nuclei lateralis intermedius caudalis, lateralis posterior lateralis and lateralis posterior medialis receive substantial projections from the suprageniculate sector of the reticular thalamic nucleus. The nucleus lateralis medialis receives an abundant projection from the three sectors (suprageniculate, pregeniculate and infrageniculate) of the reticular thalamic nucleus. Except for the lateralis intermedius caudalis, all nuclei of the lateral posterior-pulvinar complex receive consistent projections from the ventral lateral geniculate nucleus, the nucleus lateralis medialis receiving the densest one. Our findings suggest that visual, auditory, somatosensory, motor and limbic impulses from thalamic nuclei and from primary sensory and association cortical areas modulate the activity of the nucleus lateralis medialis via the reticular thalamic nucleus. The remaining nuclei of the lateral posterior-pulvinar complex are mainly modulated by sectors of the reticular thalamic nucleus that receive afferent connections from visual structures. The intrathalamic projections arising from the ventral lateral geniculate nucleus may be the way through which visuomotor inputs reach the different components of the lateral posterior-pulvinar thalamic complex.

Animals↗

The effects of lateralized adaptors on lateral position judgements of tones within and across frequency channels.

Two experiments examined the effect of highly lateralized adaptor tone pulses on the perceived intracranial location of subsequent test tones. In Experiment 1, adaptor tones of each of two frequencies, highly lateralized to opposite sides by a quarter-period interaural time difference (ITD), were found to shift the perceived intracranial location of test tones of each adaptor frequency away from the side of the adaptor. The shift in perceived location was seen for all test tone ITDs with the same sign as the adaptor tone, and sometimes extended to include test tones with small ITDs favoring the opposite ear. The generality of the effect across test tone ITDs of the same sign as the adaptor suggests that the human auditory lateralization system is built of two (left, right) hemifield-tuned azimuthal channels, and that perceived lateral location depends on the relative outputs of those two channels. In Experiment 2, the perceived location of test tones lateralized by ITD was studied in the same listeners at each of the same two frequencies, but after selective adaptation with tone pulses of only one frequency and laterality. The perceived lateral position of test tones with the same frequency as that of the adaptor underwent the same changes as seen in Experiment 1. The perceived lateral position of test tones of the nonadapted frequency usually shifted weakly in the opposite direction, i.e., in the direction expected if the second adaptor from Experiment 1 had actually been present. These data have implications both for the processes mediating selective adaptation using contingent stimuli, and for the azimuthal tuning of auditory spatial channels in man.

Acoustic Stimulation↗

A new elastographic method for estimation and imaging of lateral displacements, lateral strains, corrected axial strains and Poisson's ratios in tissues.

A major disadvantage of the current practice of elastography is that only the axial component of the strain is estimated. The lateral and elevational components are basically disregarded, yet they corrupt the axial strain estimation by inducing decorrelation noise. In this paper, we describe a new weighted interpolation method operating between neighboring RF A-lines for high precision tracking of the lateral displacement. Due to this high lateral-tracking precision, quality lateral elastograms are generated that display the lateral component of the strain tensor. These precision lateral-displacement estimates allow a fine correction for the lateral decorrelation that corrupts the axial estimation. Finally, by dividing the lateral elastogram by the axial elastogram, we are able to produce a new image that displays the distribution of Poisson's ratios in the tissue. Results are presented from finite-element simulations and phantoms as well as in vitro and in vivo experiments.

Blood Flow Velocity↗

Osteochondritis dissecans of the lateral femoral condyle following total resection of the discoid lateral meniscus.

PURPOSE: The purpose of this study was to describe the clinical presentation of 6 athletically active children with symptomatic osteochondritis dissecans (OCD) of the lateral femoral condyle following total resection for a torn discoid lateral meniscus and to discuss its cause. TYPE OF STUDY: Case series. METHODS: Six patients in whom OCD affecting the lateral femoral condyle developed after total resection of the discoid lateral meniscus participated in a detailed clinical, radiologic, and arthroscopic review. The average age at the time of meniscectomy was 9 years (range, 6 to 12 years). At a mean of 50 months (range, 36 to 65 months) after surgery they developed recurrent pain in the treated knee; all had radiologic abnormalities at the lateral femoral condyle consistent with OCD. Before the recurrence of pain, all patients had been continuously engaged in sports activity. Radiologic and arthroscopic findings of the OCD lesions were assessed. Clinical outcomes of surgical treatment for OCD were also documented. RESULTS: The radiographic evaluation showed all lesions to be in the central portion of the lateral femoral condyle on the anteroposterior views and posteriorly next to a line extending distally from the posterior femoral cortex on the lateral views. Arthroscopic evaluation revealed softening in 2 knees, a separated fragment in 2 knees, and a completely loose fragment in 2 knees. All lesions were treated surgically, including 2 drillings of the lesion, 2 fixations of separated fragment, and 2 excisions of loose bodies with drilling. At an average follow-up period of 51 months (range, 22 to 77 months), all patients but 1 were asymptomatic. CONCLUSIONS: Repeated impaction in sports activities on the immature osteochondral structures under altered mechanical force transmission after total resection of the discoid meniscus might be a predisposing factor in the development of OCD in the lateral femoral condyle.

Adolescent↗