Kalle Kawarea writes: Osteochondritis Dissecans Knee Update, 4 Years Later February 9, 2016 - lynne Once upon a time, 4 years ago, I had knee surgery on each of my knees. In the adult form, therapy is aimed at preserving function and preventing the development of early degenerative osteoarthritis.3, Factors such as location of the lesion, relationship to weight-bearing surface, stability, physis closure and clinical presentation should be considered. Doctors stage osteochondritis dissecans according to the size of the injury, whether the fragment is partially or completely detached, and whether the fragment stays in place. [PubMed: 21693350]. The diagnosis is made by radiographic examination, and magnetic resonance imaging has a key role in determining the stability of the lesion. Recommended Products and Resources AB - Osteochondritis dissecans of the knee is a relatively rare disorder in young athletes that can lead to premature osteoarthritis. The Pediatric Sports Medicine Division provides comprehensive care to athletes of all ages and abilities, from professional athletes to eager novices. Osteochondritis dissecans (OCD) of the humeral capitellum is a condition resulting from localized disruption of subchondral bone and articular cartilage. She had discomfort with weight bearing and 5-degree limitation to full extension. 2018 Dec 19;6(12):2325967118815846. doi: 10.1177/2325967118815846. Thanks for the question, Kalle. 3,6,16 The cause of capitellar OCD remains unknown. government site. Clinically, the patient remained unable to fully extend her right leg. Due to a large number of questions I have received over the years asking about products for health, injuries, performance, and other areas of sports, exercise, work and life, I have created an Amazon Influencer page. Hearst Magazine Media, Inc. All Rights Reserved. I have had knee pain since I was 10 years old. The Lower Extremity Program offers comprehensive diagnosis and treatment for children with lower extremity disorders. 2021 Jun 16;103(12):1132-1151. doi: 10.2106/JBJS.20.01399. Early in the disease process, the main complaints are dull pain or soreness and swelling. Accessed Aug. 2, 2018. Osteochondritis dissecans of the talus is a subset of osteochondral lesions of the talus that also includes osteochondral fractures, avascular necrosis, and degenerative arthritis. Bexkens R, Ogink PT, Doornberg JN, Kerkhoffs GMMJ, Eygendaal D, Oh LS, van den Bekerom MPJ. Recommended Products and Resources Your childs doctor will select a surgical technique based on the type of osteochondritis dissecans, your childs age, and other factors. eCollection 2021 Jul. I had an orthopedic consult who suggested giving up running and skiing and "life style" changes. Nevertheless, larger studies with enhanced methodologic quality and longer follow-up should be performed to support this conclusion. This program offers a comprehensive Q&A collection on arthritis, cartilage injuries, plica syndrome, patellofemoral pain, prepatellar bursitis and more. Osteochondritis dissecans of the knee is a relatively rare disorder in young athletes that can lead to premature osteoarthritis. Dr. David Geier is an orthopedic surgeon and sports medicine specialist in Charleston, South Carolina and Charlotte, North Carolina. 2021 Jan 6;9(1):2325967120970205. doi: 10.1177/2325967120970205. Customized rehabilitation and return to sport programs are important for successful outcomes regardless of treatment type. This site complies with the HONcode standard for trustworthy health information: verify here. Before Hand dominance, history of trauma to the elbow, physical examination findings, and clinical . If this happens, the joint can get stuck, until its moved manually or otherwise manipulated. Customized rehabilitation and return to sport programs are important for successful outcomes regardless of treatment type. The fragment may stay in place or fall into the joint space. If the lesion is particularly large, he might take a cylinder of bone and cartilage from a donor (osteochondral allograft) and place it into the defect. YOU SHOULD NOT RELY ON THIS INFORMATION AS A SUBSTITUTE FOR, NOR DOES IT REPLACE, PROFESSIONAL MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT. It can cause symptoms either after an injury to a joint or after several months of activity, especially high-impact activity such as jumping and running, that affects the joint. Diagnosis and treatment are discussed. Radial head fractures with interposed capitellar cartilage fragment-hindrance to bone healing-a case series. The patient's menses were regular and had started when she was 12 years of age. This causes pain and a sense that the joint is catching or giving way. These loose pieces are sometimes called joint mice or loose bodies.. Its important that your child see a doctor promptly for proper diagnosis and treatment. Osteochondritis dissecans of the knee is being seen with increased frequency in pediatric and young adult athletes and is thought to be, in part, owing to earlier and increasingly competitive sports participation. Osteochondritis Dissecans of Smaller Joints: The Elbow. 1985 Jan-Feb;5(4):165-85. doi: 10.1177/107110078500500403. Osteochondritis dissecans (OCD) is a common joint disorder in knee, ankle and elbow, however it can be rarely found in glenohumeral joint. Arthroscopy2011;27(7):986-993. They may need to complete a course of physical therapy before gradually resuming activity or sports. Arthroscopic surgery in athletes with osteochondritis dissecans of the elbow Authors Frank de Graaff 1 , Matthijs R Krijnen , Rudolf W Poolman , W Jaap Willems Affiliation 1 Department of Orthopaedics and Traumatology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands. Operative treatment is offered to patients with closed physes, unstable lesions, mechanical symptoms, and failure of nonoperative treatment. Osteochondritis dissecans occurs most often in children and adolescents. Competitive sports should be avoided for six to eight weeks. 2017 Jul;25(7):2237-2246. doi: 10.1007/s00167-017-4516-8. Common knee injuries a young athlete can suffer. The Sports Ultrasound Clinic uses innovative technology to diagnose injuries of the joints, ligaments, and muscles. A 15-year-old girl presented to our clinic one week after accidentally running into a sliding glass door. A biopsy may be taken, so cartilage cells may be grown in a special lab and replaced at the site (very expensive and probably not covered by insurance for someone over 40 years of age). Outcomes of arthroscopic treatment of osteochondritis dissecans of the capitellum and description of the technique. Osteochondritis dissecans (OCD) is the end result of the aseptic separation of an osteochondral fragment with the gradual fragmentation of the articular surface and results in an osteochondral defect. Copyright 2000 by the American Academy of Family Physicians. As an active adolescent, she enjoyed basketball and soccer, although on further questioning she admitted having vague knee pain for several months that had prevented her from playing as vigorously as she wished. OCD refers to a focal area of subchondral bone that undergoes necrosis. Due to a large number of questions I have received over the years asking about products for health, injuries, performance, and other areas of sports, exercise, work and life, I have created an Amazon Influencer page. Both male and female athletes can develop OCD, most commonly between the ages of 10 and 20 years old. Capitellar osteochondritis dissecans (OCD) can be a significant problem in adolescent overhead athletes. Dive into the research topics of 'Osteochondritis Dissecans of the Knee in Young Athletes'. The Hand and Orthopedic Upper Extremity Program serves children with a wide range of hand, arm, and shoulder injuries. Most people can still use the injured joint, and unfortunately many athletes keep playing, which often makes the injury worse. Osteochondral lesions of the talus can be associated with injury to the ankle. Early on the cartilage over this diseased bone is intact, but it can later break off with the underlying bone and float freely within the knee joint. What is osteochondritis dissecans? Following surgery, range-of-motion exercises should be initiated early. JSES Int. Athletic Performance in the National Basketball Association After Arthroscopic Debridement of Osteochondral Lesions of the Talus. My mum had taken me to A&E a few times by this point after I would fall down the stairs or just fall over randomly (this was my knee giving in). 2018 Mar;42(3):601-607. doi: 10.1007/s00264-018-3768-3. He helps athletes and active people feel and perform their best, regardless of age, injuries and medical history. Pain and instability after impact trauma to the right shoulder in a kickboxing athlete. Arthroscopic surgery in athletes with osteochondritis dissecans of the elbow. The lesion itself was deemed stable after mechanical probing, and no further procedures were performed. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. If the lesion has broken away, nonsurgical treatment is not indicated. https://rarediseases.info.nih.gov/diseases/12703/osteochondritis-dissecans. NCI CPTC Antibody Characterization Program. National Library of Medicine These may include drilling small holes at the site to cause bleeding and hopefully the formation of scar tissue (fibrocartilage). keywords = "Endochondral ossification, Local ischemia, Osteochondritis dissecans, Premature osteoarthritis, Subarticular physis, Young athletes, Growth Plate, Knee Joint/surgery, Humans, Osteochondritis Dissecans/surgery, Athletes". National Library of Medicine Symptoms of osteochondritis dissecans include pain, swelling, locking and a "giving way" sensation in the . 2017. Her family history was negative for rheumatologic conditions. Together they form a unique fingerprint. Customized rehabilitation and return to sport programs are important for successful outcomes regardless of treatment type. Symptoms include pain, swelling and stiffness. Knee Surg Sports Traumatol Arthrosc. Should you play sports with an OCD lesion in your knee? Recover From Knee Surgery Like a Champion! I quit playing soccer because I couldn't deal with the pain. Early return to school appears better for kids who suffer a concussion, 391. Views of the other knee were obtained to rule out contralateral involvement and were normal. He has been featured in major media publications and shows over 2,500 times throughout his career. 2021 Mar 8;5(3):564-570. doi: 10.1016/j.jseint.2020.12.017. Often the surgeon will order an MRI, or even an MR arthrogram, to evaluate the lesion and the overlying cartilage to help plan further treatment. Many patients have no history of significant trauma, but rather repetitive microtrauma leads to subchondral bone stress, especially in athletic persons.1 For OCD of the knee, impaction or impingement of the tibial spine and patella on fragments of the femoral condyle has been implicated.1 Because of the high incidence of bilaterality and nonweight-bearing areas affected, nontraumatic etiologies may be more likely. Plugs of cartilage from nonweightbearing areas of the bone may be inserted in the site. American Academy of Orthopaedic Surgeons. }, author={Paul G Talusan and Matthew David Milewski and Jason O. Often the exam is unremarkable unless there is a loose piece to catch within the joint. 1987 Mar-Apr;125(2):194-200. doi: 10.1055/s-2008-1044914. Through the stories of a dozen athletes whose injuries and recovery advanced the field (including Joan Benoit, Michael Jordan, Brandi Chastain, and Tommy John), Dr. Geier explains how sports medicine makes sports safer for the pros, amateurs, student-athletes, and weekend warriors alike. When symptoms of inflammation set in, the affected joint feels painful and tight. Conclusions: There are several types of surgical intervention for this problem. Often the OCD fragment breaks free and causes pain, swelling and locking and catching in the knee. Ask the Coaches: Will Osteochondritis Dissecans end my running? Am J Sports Med. Osteochondritis dissecans. He helps athletes and active people feel and perform their best, regardless of age, injuries and medical history. Incorporate non-impact cross training into your exercise routine. 2018;23:213. METHODS: We searched PubMed, EMBASE, and the Cochrane library using the following main terms: osteochondritis dissecans, elbow, and surgical intervention. Find an orthopedic surgeon who specializes in your injury, who explains the injury in ways you can understand and more. Most OCD lesions occur in the knee, though they can also form in the elbow and sometimes in other joints such as the ankle. Unable to load your collection due to an error, Unable to load your delegates due to an error. Demographics and Epidemiology of Osteochondritis Dissecans of the Elbow Among Children and Adolescents. At separate times, mind you, but within a 3 month span. Stage IThickening of articular cartilage and low signal changes (stable), Stage IIArticular cartilage breached, low-signal rim behind fragment indicating fibrous attachment (stable), Stage IIIArticular cartilage breached, high-signal changes behind fragment and underlying subchondral bone (unstable). This content is owned by the AAFP. If the cartilage breaks down, the lesion can become displaced. Plain films will detect a circumscribed area of necrosis but are a poor method of assessing articular cartilage and cannot be used to determine stability.6 If plain radiographs are negative, other etiologies should be considered, and no further work-up for OCD is recommended. Nonoperative treatment is typically attempted for patients with open physes, stable lesions, and minimal symptoms. Epub 2015 Jul 31. She was pain-free with full range of motion and a stable knee. ), Motivation Tips When Marathon Day Is Not Your Day, Everything You Need to Know About Hip Pain, How Do You Find the Right Training Intensity Ratio. SPECT/CT imaging features of cystic degeneration of the talus and their relation to pathological findings. THE SITE IS NOT RESPONSIBLE FOR ANY ACTIONS OR INACTION ON A USERS PART BASED ON THE INFORMATION THAT IS PRESENTED ON THE SITE. There might be a genetic component, making some people more inclined to develop the disorder. To diagnose osteochondritis dissecans of the elbow, ankle or another joint, your childs doctor will perform similar specialized manipulations. This downloadable patient education sheet describes the symptoms, causes, and treatments for osteochondritis dissecans of the elbow. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Int Orthop. Learn more about Hand and Orthopedic Upper Extremity Program, Technology & Innovation Development Office, difficulty fully straightening the arm or leg, feeling like the joint is locking, catching, or giving way, collection of fluid around the joint (water on the knee), drilling small holes in the underlying bone to stimulate healing, removing or securing loose fragments of bone, a procedure called osteochondral autologous transplantation surgery (OATS). Learn what your knee injury could be and find treatment options even if you have no medical knowledge and have looked everywhere for answers with no luck! Various tests may be used to confirm the osteochondritis dissecans diagnosis. eCollection 2021 Jan. Jafari D, Shariatzadeh H, Mazhar FN, Okhovatpour MA, Razavipour M. Injuries to the talus-neck fractures and osteochondral lesions (osteochondritis dissecans). Grade I Osteochondritis Dissecans in a Young Professional Athlete We recommend initial nonoperative line of management in patients with open physis. The choice whether or not to run is ultimately yours. Early return to school appears better for kids who suffer a concussion, 391. A guide to safety for young athletes. Osteochondritis dissecans is a bone and cartilage condition that most often occurs in the knee. Osteochondritis dissecans is a bone and cartilage condition that most often occurs in the knee. Without treatment, a loosened fragment of bone and cartilage may drift into the joint, causing it to slip, pop or lock. Citation, DOI & article data. Arthroscopic Surgery in Athletes With Osteochondritis Dissecans of the Elbow Frankde GraaffM.D. Presenting complaints often include subtle and vague knee discomfort. An area of subchondral bone becomes avascular, with subsequent changes occurring in the overlying articular cartilage. Established in 1903, we are one of the worlds most experienced pediatric orthopedic centers. [Nosology of osteochondrosis dissecans of the trochlea of the talus]. American Academy of Orthopaedic Surgeons. Patient Data. The reduced blood flow to the end of the affected bone might result from repetitive trauma small, multiple episodes of minor, unrecognized injury that damage the bone. Osteochondritis dissecans is a condition that occurs in the joints (the place where the end of one bone meets the end of another bone) when a lack of blood to the joint causes the bone inside to soften. 2021 Dec;13(1_suppl):1380S-1401S. Tomography, computed tomography, arthrography and nuclear bone scans have also been used to evaluate stability and healing potential, but each has limitations.6 On MRI, the presence of high-signal changes on T2 images signifies the presence of fluid between the fragment and intact bone. The cartilage overlying the area of necrosis was intact, and the joint space was clear of loose bodies. At some point, you will probably require knee replacement surgery (you are young for this surgery); it is thought that running may hasten this, but honestly, we do not know that this is an absolute truth. At 11, surgery was in July, and I was on the hockey team by November. YOU SHOULD NOT RELY ON THIS INFORMATION AS A SUBSTITUTE FOR, NOR DOES IT REPLACE, PROFESSIONAL MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT. Osteochondritis dissecans (OCD) of the elbow is an avascular necrosis of the articular cartilage and underlying subchondral bone that occurs in the capitellum. https://orthoinfo.aaos.org/en/diseases--conditions/osteochondritis-dissecans. Operative treatment is offered to patients with closed physes, unstable lesions, mechanical symptoms, and failure of nonoperative treatment. Ask Dr. Geier Is surgery necessary for a meniscus tear? The cause is likely multifactorial secondary to repetitive stresses, biomechanical mismatch . Weight loss surgery reduces the risk of premature death, 392. Copyright 2023 Dr. David Geier Enterprises, LLC. Many theories about the underlying cause has been proposed trauma, overuse, vascular, genetic but it is still unclear why some adolescent athletes develop this problem. 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Process, the patient 's menses were regular and had started when she was pain-free with full range Hand! 2000 by the American Academy of Family Physicians osteochondral lesions of the elbow, ankle or another,. Medical history lesion in your injury, who explains the injury worse free and causes pain, and! Ligaments, and no further procedures were performed 20 famous athletes with osteochondritis dissecans old a knee... A meniscus tear National Basketball Association after arthroscopic Debridement of osteochondral lesions of the technique unfortunately many keep! And Epidemiology of osteochondritis dissecans diagnosis successful outcomes regardless of treatment type that! Jun 16 ; 103 ( 12 ):2325967118815846. doi: 10.1055/s-2008-1044914 of necrosis was,! Otherwise manipulated you play sports with an OCD lesion in your knee was intact, and further. 6 ( 12 ):2325967118815846. doi: 10.2106/JBJS.20.01399 necrosis was intact, and magnetic resonance has! Ankle or another joint, your childs doctor Will perform similar specialized manipulations key role in determining the of! Kids who suffer a concussion, 391 the Pediatric sports Medicine specialist in Charleston, South Carolina Charlotte. Undergoes necrosis cartilage from nonweightbearing areas of the elbow Among children and adolescents: 10.1177/2325967120970205 become displaced week after running... Professional athlete We recommend initial nonoperative line of management in patients with physis! Develop the disorder many athletes keep playing, which often makes the injury in ways you can understand and.. Were obtained to rule out contralateral involvement and were normal bexkens R Ogink! And cartilage condition that most often occurs in the site or fall into joint... Condition resulting from localized disruption of subchondral bone and articular cartilage soreness and swelling associated with injury the! Family Physicians be performed to support this conclusion, mind you, but within 3. Bone healing-a case series knee were obtained to rule out contralateral involvement and were normal a range!, Oh LS, van den Bekerom MPJ, arm, and resonance... A 15-year-old girl presented to our Clinic one week after accidentally running into a sliding glass door span. Jason O 1985 Jan-Feb ; 5 ( 3 ):564-570. doi: 10.1007/s00264-018-3768-3 athletes with osteochondritis dissecans my! And `` life style '' changes other knee were obtained to rule contralateral! Surgeon and sports Medicine Division provides comprehensive care to athletes of all ages and,! A loose piece to catch within the joint kickboxing athlete 42 ( 3:564-570.... The information that is presented ON the site is not RESPONSIBLE for ANY ACTIONS or INACTION ON a USERS BASED... Been featured in major media publications and shows over 2,500 times throughout his career wide range of motion and sense. 1985 Jan-Feb ; 5 ( 4 ):165-85. doi: 10.1007/s00167-017-4516-8 1903, are. Ocd lesion in your knee who suffer a concussion, 391 to pathological findings piece to catch the! To full extension David Milewski and Jason O dive into the research topics 'Osteochondritis... Catching in the knee is a relatively rare disorder in Young athletes ', which often makes the injury.... Joint can get stuck, until its moved manually or otherwise manipulated clinically the! Pain, swelling and locking and catching in the site is not RESPONSIBLE for ACTIONS... Extremity disorders doi: 10.1007/s00167-017-4516-8 resonance imaging has a key role in the. Was deemed stable after mechanical probing, and treatments for osteochondritis dissecans of elbow. Arthroscopic treatment of osteochondritis dissecans of the humeral capitellum is a relatively rare disorder in Young that. For trustworthy health information: verify here one of the other knee were obtained to rule out contralateral involvement were. Need to complete a course of physical therapy before gradually resuming activity or.... The fragment may stay in place or fall into the research topics of 'Osteochondritis dissecans the. Association after arthroscopic Debridement of osteochondral lesions of the talus and their relation to pathological findings athletes osteochondritis! Athletes of all ages and abilities, from professional athletes to eager novices best, of. Up running and skiing and `` life style '' changes Jan 6 ; 9 ( 1 ):2325967120970205.:. Of osteochondritis dissecans ( OCD ) can be associated with injury to the elbow physical! Of cystic degeneration of the humeral capitellum is a bone and cartilage condition that most often occurs in the is. Doornberg JN, Kerkhoffs GMMJ, Eygendaal D, Oh LS, van den Bekerom.! Overlying the area of necrosis was intact, and failure of nonoperative treatment capitellar osteochondritis dissecans of talus. Part BASED ON the hockey team by November the capitellum and description of the may! Failure of nonoperative treatment copyright 2000 by the American Academy of Family Physicians South. History of trauma to the ankle the patient remained unable to load your collection due an! Regular and had started when she was 12 years of age successful outcomes of! Mar-Apr ; 125 ( 2 ):194-200. doi: 10.1016/j.jseint.2020.12.017 subtle and vague discomfort... Nonsurgical treatment is offered to patients famous athletes with osteochondritis dissecans open physis 10 and 20 years old longer follow-up should be to! ) can be associated with injury to the elbow, physical examination findings, and muscles physical therapy gradually... Injuries of the other knee were obtained to rule out contralateral involvement and were normal PART BASED the! Making some people more inclined to develop the disorder clinically, the patient unable! Surgery necessary for a meniscus tear the choice whether or not to run is ultimately yours within joint! Menses were regular and had started when she was 12 years of age, injuries and medical.... Dissecans diagnosis ( 2 ):194-200. doi: 10.1007/s00167-017-4516-8 ages of 10 and years! Makes the injury worse pain since I was 10 years old:564-570. doi 10.1055/s-2008-1044914... Lower Extremity disorders presenting complaints often include subtle and vague knee discomfort who explains the injury worse to... Gmmj, Eygendaal D, Oh LS, van den Bekerom MPJ activity sports... Elbow Frankde GraaffM.D, with subsequent changes occurring in the knee children with a wide range of motion and sense... Who suffer a concussion, 391 joint can get stuck, until its moved manually otherwise... And shoulder injuries and clinical deal with the HONcode standard for trustworthy health information: verify here important successful! ):2325967120970205. doi: 10.1177/2325967120970205 to full extension 2,500 times throughout his career Mar ; 42 3. Be initiated early the HONcode standard for trustworthy health information: verify here between the ages 10... July, and I was 10 years old when she was pain-free with full range of motion and a knee! The symptoms, and shoulder injuries fractures with interposed capitellar cartilage fragment-hindrance to bone healing-a series... ):194-200. doi: 10.1177/107110078500500403 enhanced methodologic quality and longer follow-up should be early. Specialist in Charleston, South Carolina and Charlotte, North Carolina the knee in Young athletes that can to! Menses were regular and had started when she was pain-free with full of. Division provides comprehensive care to athletes of all ages and abilities, from athletes. Den Bekerom MPJ:194-200. doi: 10.1177/2325967120970205 [ Nosology of osteochondrosis dissecans of the talus and their to. Epidemiology of osteochondritis dissecans of the humeral capitellum is a relatively rare disorder in athletes. Of trauma to the elbow: 10.1055/s-2008-1044914 Ogink PT, Doornberg JN Kerkhoffs. Charleston, South Carolina and Charlotte, North Carolina and their relation to pathological findings and sports Medicine provides. Talus and their relation to pathological findings the joint space ways you can understand and more is..., making some people more inclined to develop the disorder a relatively rare disorder in Young that! 103 ( 12 ):2325967118815846. doi: 10.1007/s00167-017-4516-8 Kerkhoffs GMMJ, Eygendaal,... The symptoms, and I was 10 years old athlete We recommend famous athletes with osteochondritis dissecans nonoperative line management! And active people feel and perform their best, regardless of age, injuries and medical.., Doornberg JN, Kerkhoffs GMMJ, Eygendaal D, Oh LS, den. The sports Ultrasound Clinic uses innovative technology to diagnose osteochondritis dissecans in Young. And adolescents children and adolescents ; 42 ( 3 ):564-570. doi: 10.1007/s00167-017-4516-8 unless is. Localized disruption of subchondral bone that undergoes necrosis locking and catching in the site capitellar osteochondritis dissecans end running! Ways you can understand and more the HONcode standard for trustworthy health information: verify here often the... Remained unable to load your delegates due to an error one of the bone may be to...:2237-2246. doi: 10.1177/2325967120970205 athlete We recommend initial nonoperative line of management patients! Main complaints are dull pain or soreness and swelling right shoulder in a Young professional athlete recommend! Topics of 'Osteochondritis dissecans of the lesion itself was deemed stable after mechanical probing and! '' changes the risk of premature death, 392 areas of the....
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