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Osteochondritis Dissecans

27th August 2018

Osteochondritis dissecans is a rare condition caused when a fragment of bone becomes loose in the joint. The condition’s cause differs depending on your age. For adults, Osteochondritis Dissecans forms after the physis or epiphyseal plate has closed, while for young people, it can occur while still growing.

It is not only limited to the knee but can occur in the elbow, ankle, wrist, hand, shoulder or hip. The exact causes are unknown but it is believed there a number of contributing factors responsible, including:

  • Biochemical
  • Genetic predisposition
  • Repetitive trauma
  • Ischaemia
  • Ligamentous laxity
  • Abnormal ossification

Certain sports, such as rugby, football, boxing or running may also be a cause and can make the condition worsen significantly quicker.

The four stages of Osteochondritis Dissecans

There are four stages to the condition, with each stage increasing the severity:

  • Stage 1 - the articular cartilage will thicken.
  • Stage 2 - the articular cartilage is interrupted.
  • Stage 3 - the underlying subchondral bone undergoes changes
  • Stage 4 - bone has become loose in the joint

Symptoms of Osteochondritis Dissecans

Osteochondritis Dissecans is likely to display symptoms during a person’s teenage years with knee pain being the first signal. Other symptoms include swelling, a sensation in the knee, joint locking and a feeling that the joint is going to give way.

If you suspect Osteochondritis Dissecans, it is important that you make an appointment with your GP as soon as possible so they can make a diagnosis and prescribe suitable treatment. Your doctor can diagnose your condition in a number of ways, including:

  • An X-ray
  • A magnetic resonance imaging (MRI) scan
  • A computed tomography (CT) scan
  • Scintigraphy

Treatment

The earlier the condition is diagnosed, the better outlook for recovery. If the condition is caught while you are young, there is a greater chance of quicker healing. Otherwise, aggressive treatments may need to be used.

Non-drug treatments include stopping all activities, limiting walking and attending physiotherapy regularly to strengthen the muscles around the knee. Immobilising or protecting the knee joint with a brace are also viable options.

If the pain is unbearable, painkillers and other NSAIDS can be used to reduce it but will not alleviate the disease.

Surgical solutions are only taken as a last resort, for severe cases or when other treatments have not worked. Keyhole surgery or arthroscopy is usually the method used for one of the following options:

  • Arthroscopic subchondral drilling
  • Arthroscopic excision, drilling and curettage
  • Open removal of all loose bones
  • Bone grafting
  • Autologous chondrocyte transplantation

Depending on the type of surgery you have undergone, recovery can take between 6-10 weeks. Patients should ensure they rest to allow the injury to heal, follow the instructions of any doctors or physiotherapists and make an appointment should symptoms persist.

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