Significant Differences in the Presentation, Diagnosis, and Management of Juvenile Osteochondritis Dissecans Exist Among Asia‐Pacific and European Surgeons
Si Jian Hui, Jacqueline Jin Li Liew, Khim Yew Chew, Ryan Wai Keong Loke, James Hoi Po Hui, Rishi MalhotraPurpose
To compare diagnostic and treatment preferences for juvenile osteochondritis dissecans between Asia‐Pacific and European surgeons.
Methods
Between January 2024 and July 2024, an electronic survey was distributed to orthopaedic surgeons affiliated with Pediatric Research in Sports Medicine Asia‐Pacific (n = 54 invited). Responses were compared with data from the 2023 European Society of Sports Traumatology, Knee Surgery and Arthroscopy survey. Domains included clinical presentation, imaging preferences, nonoperative strategies, operative techniques, and follow‐up protocols. Proportions were compared using χ 2 or Fisher's exact tests ( P < .05).
Results
Fifty‐four surgeons (100%) responded to our survey. A total of 104 surgeons were analyzed (54 Asia‐Pacific, 50 Europe). Trauma was more frequently cited as a presenting factor in Asia‐Pacific (knee: 100% vs 17%; ankle: 100% vs 21%; P < .001). European surgeons relied more on magnetic resonance imaging for knee juvenile osteochondritis dissecans (100% vs 66%; P < .001), whereas Asia‐Pacific surgeons more frequently used computed tomography (88% vs 17%; P < .001) and arthroscopy for stability assessment (88% vs 48%; P < .001). Nonoperative management differed, with casting and bracing more common in Asia‐Pacific (50% vs 0%; P < .001), whereas nonsteroidal anti‐inflammatory drug use was more frequent in Europe (21% vs 0%; P < .001). Operative strategies diverged significantly, with European surgeons favoring microfracture (48% vs 0%; P < .001) and debridement (50% vs 18%; P = .002), whereas Asia‐Pacific surgeons favored osteochondral autograft (68% vs 33%; P = .001) and antegrade drilling (84% vs 48%; P < .001).
Conclusions
Significant regional differences exist between Asia‐Pacific and European surgeons in the presentation, diagnostic evaluation, and management strategies for juvenile osteochondritis dissecans.
Clinical Relevance
Marked regional variation exits in the diagnostic and therapeutic management of juvenile osteochondritis dissecans. These differences influence imaging selection, operative thresholds, and surgical technique choice. Understanding such variability is essential for developing international consensus guidelines and ensuring consistent, evidence‐based care across various health care systems.