It is a disorder in which cartilage falls off in the joints, and it often occurs in elementary and junior high school students (more common in men – 2:1, and who are in their 10s) in their growing years. In the knee joint, 85% of the inside of the femur and 15% of the outside of the femur are common, and rarely in the patella.(1)
Do Osteochondritis Dissecans Require Surgery?
The osteochondritis dissecans has more severe implications for growing children and adolescents. Osteochondritis dissecans lesions are prone to differentiate inside the joint from the underlying bone and cartilage, and might even detach and float. Surgery might be required in these situations.
Osteochondritis dissecans treatment can involve non-operative as well as surgical interventions. Surgical care is suggested primarily by taking into account the stabilization of the lesions, clinical symptoms, and physical closure. Other factors are also considered including repetitive trauma, inflammation, degeneration, etc.
How Long Does Osteochondritis Dissecans Take To Heal?
Loose fragments might get entirely detached from the bone end. Osteochondritis dissecans, particularly affecting the joints such as ankles, elbows, and knees tend to become more severe. Full recovery normally takes about 3 months or even more. After a successful recovery, the problem usually does not return or cause long-term issues.(5)
Causes And Symptoms Of Osteochondritis Dissecans
Anyone can have osteochondritis, but it often occurs in young men aged 10 to 20 years. It affects athletes playing sports, especially gymnasts and baseball players. It occurs in mature bone in adults and in developing bone in young people.
It is thought that the stress is placed on the bone under the cartilage due to repeated stress and trauma caused by sports. When the subchondral bone is necrotized due to blood flow disorder, the osteochondral fragments (bundles) are separated, and as they progress, they are released into the joints. Initially, there are no specific symptoms other than post-exercise discomfort and dull pain.
If cracks or degeneration occur on the surface of articular cartilage, the pain will increase and it will be a problem in sports. Furthermore, if the osteochondral fragments are released into the joint, it may cause a feeling of being caught or misaligned when the knee is bent and stretched, and if it is caught in the joint, the knee will lock and become immobile (locking).(2)
Most common symptoms of dissecting osteochondritis include the following:
- Clicking sound when joints are moved
- Decreased joint movement, such as the inability to fully extend arms and legs
- Joints becoming sticky or feeling of fixation
- Pain after movement
- Rigidity after rest
- Swelling of the affected joint
Diagnosis Of Osteochondritis Dissecans
It may be overlooked in the early days because it is difficult to see with normal X-rays, so it is useful to shoot from a special direction.
If osteochondritis dissecans is doubted, an x-ray is done to look at all joint sides. If an x-ray shows indications of osteochondritis, it will be compared to other joints. After that, nuclear magnetic resonance imaging (MRI) and computed tomography (CT) will be performed. These tests will tell you if you still have loose sections (loose pieces) or if they have moved to the joint. (3)
Treatment For Osteochondritis Dissecans
If the loose piece is unstable (meaning it has moved to the joint), it may require surgery to remove and fix it. Stable loose pieces may not require surgery, but require rest, supporting the joints during sports, and treatment with drugs like ibuprofen to reduce pain and inflammation. There is a case.
If non-surgical treatment is suggested, discomfort-causing activities or competitive sports should be avoided for 6-8 weeks. Also, stretching exercise and swimming are recommended as physical therapy.
Young adults have the opportunity to return to normal levels of activity, but they cannot continue the sport with repetitive movements such as baseball. Older adults are more likely to require surgery and are less likely to later develop arthritis in the affected joint or completely heal. (4)
- Pascual-Garrido C, Southworth TM, Slabaugh MA, et al. Osteochondritis Dissecans. 2019.
- Nguyen JC, Degnan AJ, Barrera CA, Hee TP, Ganley TJ, Kijowski R. Osteochondritis Dissecans of the Elbow in Children: MRI Findings of Instability. American Journal of Roentgenology. 2019;213(5):1145-1151.
- Ward O, Leach S, McMahon A-M, Tattersall RS, Nicolaou N, Hawley D. P09 Juvenile osteochondritis dissecans in juvenile idiopathic arthritis: a case series review. Rheumatology. 2019;58(Supplement_4):kez415. 005.
- Perdisa F, Kon E, Sessa A, et al. Treatment of knee osteochondritis dissecans with a cell-free biomimetic osteochondral scaffold: clinical and imaging findings at midterm follow-up. The American journal of sports medicine. 2018;46(2):314-321.
- Sanders TL, Pareek A, Obey MR, et al. High rate of osteoarthritis after osteochondritis dissecans fragment excision compared with surgical restoration at a mean 16-year follow-up. The American journal of sports medicine. 2017;45(8):1799-1805.
- Osteochondritis or Osteochondritis Dissecans: Causes, Symptoms, Treatment
- What is Osteochondritis Dissecans of Knee Joint and How is it Treated?