This study primarily aims to determine whether patients diagnosed with osteochondritis
      dissecans (OCD) of the knee experience psychological stress due to their diagnosis and
      treatment plan. Secondarily, this study aims to determine whether knee OCD patients
      experience a change in stress and depression as they progress through their standard-of-care
      treatment plan, and whether they have impaired psychological readiness for return to sport.

Psychological Response and Readiness Associated With OCD of the Knee

Osteochondritis Dissecans Knee

Psychological Stress

Young athletes with poor psychological responses to injury and recovery may be at risk for
      suboptimal rehabilitation and return to sports. The issues of psychological readiness and
      fear/anxiety of reinjury are well documented in the treatment of ACL injuries in young
      athletes. To the investigative team's knowledge, no studies have examined the psychological
      response and psychological readiness to return to sports in pediatric and adolescent patients
      undergoing treatment for osteochondritis dissecans (OCD) of the knee.

      OCD is a focal, idiopathic alteration of subchondral bone with risk for instability and
      disruption of adjacent articular cartilage that may result in premature osteoarthritis. It
      generally affects a young population between 6 and 19 years of age, with highest prevalence
      between the ages of 12 and 19 years of age. This condition can be treated both conservatively
      and surgically depending on the age of the patient, size of the lesion, severity and
      instability of the bone & cartilage, and previous treatment. The unclear etiology of this
      condition, the delayed / prolonged pre-diagnosis symptoms, varied treatment options, and
      unpredictable healing timelines are all factors that families and patients find frustrating
      about this condition. The investigators of this study believe that this leads to higher than
      normal psychological stress at the time of diagnosis and throughout treatment of this
      condition.

      Improved understanding of the psychological stress and readiness to return to sport in the
      treatment of knee OCD can help patients, their families, and clinicians alike. Awareness can
      help clinicians provide the appropriate outreach and counseling for patients at risk for
      increased psychological stress. Improved psychological states and readiness can improve both
      physical and mental well-being.

Surgical Treatment

Nonoperative Treatment

Psychological Response and Readiness to Return to Sports Associated With the Diagnosis and Treatment of Osteochondritis Dissecans of the Knee

A CRIES-13 score is a continuous number between 0 and 65 (the higher the score, the more severe the outcome). CRIES items will be keyed to the diagnosis and treatment of OCD (i.e., the patient is asked to indicate how frequently each comment was true for them during the past 7 days with respect to their experience with OCD).
The CRIES is a 13-item, 4-point scale assessing psychological distress. It has three subscales: intrusion, avoidance, and arousal. It is based off the Impact of Event Scale (IES) and is designed to address misinterpretation of items by children on the IES. It is designed for children 8 years of age and above to read independently. If the score is greater than or equal to 30, the score is indicative of increased subjective stress.

Assistant Professor of Orthopedic Surgery, Harvard Medical School

Assesses the thoughts or feelings about the world in the context of environmental or internal challenges. Patients will complete at the time of enrollment, any additional clinical visit, including 3 months, 6 months, 9 months, 1 year, and 2 years post diagnosis. There are 19 questions that are rated on a 1-5 scale. Overall, this outcome measure is scored 18-95 (lower score = less stress). Raw scores are then converted into T-scores. The investigators expect scores to increase during the early stages of treatment by at least 5 points (MCID) in the first 3 months and then decrease over time returning to baseline or above at 1- to 2-year follow up post diagnosis.

This questionnaire assesses for anxiety in children and adolescents (ages 11-17). Patients will complete at the time of enrollment, any additional clinical visit, including 3 months, 6 months, 9 months, 1 year, and 2 years post diagnosis. There are 8 questions that are rated on a 1-5 scale. Overall, this outcome measure is scored 14-70 (higher score = greater severity in depression). Raw scores are then converted into T-scores. The investigators expect scores to increase during the early stages of treatment by at least 5 points (MCID) in the first 3 months and then decrease over time returning to baseline or above at 1- to 2-year follow up post diagnosis.

This questionnaire assesses for depression in children and adolescents (ages 11-17). Patients will complete at the time of enrollment, any additional clinical visit, including 3 months, 6 months, 9 months, 1 year, and 2 years post diagnosis. There are 8 questions that are rated on a 1-5 scale. Overall, this outcome measure is scored 14-70 (higher score = greater severity in depression). Raw scores are then converted into T-scores.

Questionnaire used to measure the psychological impact of returning to sport after ACL reconstruction surgery. Patients will complete this questionnaire at the clinic visit when they are cleared to RTS, 1 year and 2 years post diagnosis. There are 12 questions that are rated on a 0-10 scale. Overall, this outcome measure is scored 0-100 (higher score = more psychologically ready to RTS). A score greater than or equal to 77% indicates that the patient is psychologically ready to RTS.

Patient's in this cohort will undergo surgical treatment for OCD of the knee.

Patient's in this cohort will undergo nonoperative treatment for OCD of the knee.

Psychological Response and Readiness Associated With OCD of the Knee

About this trial

Study ID

Status

Type

Placebo

Accepting

Trial Timing

What is this trial about?

What are the participation requirements?

Locations

Location

Status