Osteochondritis dissecans disease affects male teenagers & young adults.(1) The essential point of any treatment is to accomplish the mending of the subchondral bone, and conservation of the articular ligament as section detachment may prepare for the ensuing cause of osteoarthritis.(1)
Large-sized contusion, a bruise on a weight-bearing area, & older age of the patient worsens the prognosis of the Osteochondritis dissecans patient.(2)
Osteochondritis dissecans is generally caused by repetitive trauma as it is the most common reason especially occurring in the younger age group. The age at the time of presentation and diagnosis is about 10 to 16 years in most of the cases except the adult-onset osteochondritis dissecans where the mean age is about 17 to 25 years. It is a rare disease and is associated with children pursuing sports commonly.(3)
There is a difference in the male to female ratio in the number of cases because it is more commonly known to affect the male population as compared to the female population. The frequency of the condition is about 2 to 3: 1 with 6 to 9 cases per 10000 men whereas only about 3 cases per 10000 women. Many joints can be involved in this condition but the most common out of all is knee joint with about 75 % cases occurring in it. It is followed by an elbow joint at 6 % and ankle joint at 4 % and the rest of the all comprises 15 % in total.
What Is The Prognosis For Osteochondritis Dissecans?
Although there has been widespread research going in the orthopedics field, strangely, most of the physicians are not exposed to this condition very frequently. It is very difficult to comment on the prognosis because adult-onset and childhood-onset is osteochondritis dissecans has not been referred separately but their data has been compiled together. Even then few studies have studied them separately and have found that there is about 90 to 98 % of success in the treatment of osteochondritis dissecans within 3 to 4 months in the case of childhood-onset disease whereas the percentage for adult-onset osteochondritis dissecans is nowhere near about this number.
Now talking about them separately, in the case of knee joint if there is no loose body in the joint space at the time of presentation, the cure rate is about 94 % within 3 months with only conservative treatment. In the case of involvement of elbow joint the success rate is about 95 % with conservative treatment within a few months. There has been not much data available in the case of the ankle joint in the younger generation whereas in adult-onset osteochondritis dissecans the success is about 90 % with conservative treatment.(3)
In those cases of osteochondritis dissecans where there was a need for surgical intervention, the arthroscopic approach has more success as compared to open procedures. There is about 80 % chance of complete cure with the arthroscopic approach in Juvenile onset disease where is it is somewhat less and stands at 70 % in adult-onset cases. The open approach for the surgery has enjoyed the success of about 60 % to 70 % but it is to be noted that this approach is used only when the severity of the condition is the highest.
Lifestyle Changes For Osteochondritis Dissecans
Once the condition has been diagnosed, it is very necessary to keep the causative factors out of the equation. Sports or other activities which have been leading to this condition has to be avoided. Immobilization and bed rest is to be done in the initial phase and then light exercises can be pursued to keep the joint moving. Weight reduction has to be sought if it is one of the factors for this condition. Time to time follow with the doctor and needed radiological investigations must be done to keep up with the progression of the condition.
The prognosis of this condition is very good if detected early and also is Juvenile onset. It enjoys a success rate of about 95 % in such cases with only conservative treatment making it a fairly treatable disease. Only a few simple lifestyle modifications are required and regular follow-up has to be done with the physician.
- What is Osteochondritis Dissecans of Knee Joint and How is it Treated?
- Osteochondritis or Osteochondritis Dissecans: Causes, Symptoms, Treatment