Patient with right knee pain, evaluate osteochondrosis dissecans lesion. Per chart review, Patient had a repair in 2010 and had a recent injury. MENISCI: The lateral and medial menisci are intact.ARTICULAR CARTILAGE AND BONE: Again seen is a large osteochondral defect in the posterior aspect of the medial femoral condyle. The previously seen fragment within this defect has dislodged and now lies along the posterior rim of the medial tibial plateau. The fragment is just under 2 cm in its greatest dimension. There is cyst formation and edema within the marrow deep to the medial femoral condyle defect, which appears similar to that seen on the prior study. There is new edema within the marrow of the posterior aspect of the medial tibial condyle subjacent to the displaced osteochondral fragment.Also again seen is cyst formation within the anterior aspect of the medial femoral condyle with heterogeneity of the overlying cartilage that appears similar to that seen on the prior study, likely representing an additional osteochondral defect that we suspect is stable. There is also focal degeneration of the anterior aspect of the lateral femoral condyle with small cysts in the underlying marrow, unchanged from the prior study. Small tricompartmental osteophytes are noted.LIGAMENTS: Anterior cruciate ligament appears intact. The posterior cruciate ligament appears intact. The medial collateral ligament appears intact. The lateral collateral ligament appears intact.EXTENSOR MECHANISM: The extensor mechanism is intact.ADDITIONAL
1.Large osteochondral defect along the posterior aspect of the medial femoral condyle with displacement of the osteochondral fragment posterior to the medial tibial plateau and edema in the underlying posterior tibia. Additional loose bodies are noted both anteriorly and posteriorly within the joint.2.Osteochondral lesion along the anterior aspect of the distal femur appears similar as that seen on the prior study.