Osteochondritis dissecans is a disorder in which the cartilage of the elbows and knees peels off. When worsened, joint movement is severely restricted, and severe pain and joint edema (accumulation of water in the joint) may occur. Frequent and continuous trauma causes irreparable damage to bone and cartilage, which can cause osteochondral degeneration or exfoliation. This may explain why the disease occurs in athletes or people with a lot of activity.(1)
What Leads To Osteochondritis Dissecans?
When you move your elbows and knees, cartilage usually provides cushioning and lubrication so you can bend smoothly without pain. However, for some reason, cartilage may come off with the bone.
Osteochondritis dissecans occurs mostly in men between 16 and 25 years old; knee and elbow joints are common, and hip, shoulder, ankle, or metatarsophalangeal joints are also visible. One joint is often involved without systemic symptoms. There may be a dull pain in the joints, which increases after the activity and reduces after the rest, and the joints swell slightly. These free bodies can cause joint strangulation, hematoma, and traumatic arthritis.
On examination, joint swelling, effusion, tenderness, and masses can be seen, and the movement is limited, and the pronunciation can be heard. Muscle atrophy. The medial and lateral femoral condyles, the patellar articular surface, the humeral lateral condyle, the radial head, and the medial and talus of the ankle can all develop the disease and can cause tenderness.
Osteochondritis dissecans tend to occur when playing sports that use joints hard such as baseball and soccer and tend to be children in their teens and 20s who are active in sports like club activities and club activities every day.
In the early stages, the cartilage is not completely detached, which is a symptom of awkwardness and discomfort when moving joints. As the symptom progresses, the peeled cartilage moves around in the joint, making you feel as if something is being caught, and if you get caught in the joint, you cannot easily bend it. Also, severe pain may occur when moving the joint, or joint edema may occur, in which water accumulates in the joint.(2)
Can Osteochondritis Dissecans Be Cured?
Osteochondritis dissecans is a sports disorder that is common in growing children. In the early days, it can be cured by pressing and resting, but recurrent adulthood and severe cases of children may be difficult to heal naturally, and surgery may be necessary. Of course, you should start treatment early, but you should take a good rest to prevent the onset.
There is no remedy, but based on the size and position of the lesion and the patient’s age and severity of symptoms, the disease may be managed by several means.(3)
What Are The Treatments For Cutaneous Osteochondritis?
If the child is still in an early stage and still has bone growth, conservative therapy is used to fix the joint where the cartilage has been detached with a supporter. Resting for a few months will usually relieve the symptoms. However, unlike normal bone, cartilage is a difficult part to regenerate. Even if it gets a little better, it will reoccur soon if you move it again. Be sure to get permission from your doctor when you resume sports.
Adult osteochondritis dissecans is difficult to cure with conservative therapy. The same applies to severe osteochondritis in children as long as it is severe.
In these cases, arthroscopic surgery is performed to remove the loose pieces of cartilage. Since the incision is small, early recovery can be expected and the burden on the body can be minimized. After removing a piece of cartilage, the treatment depends on the symptoms. In poor conditions, bones may be fixed or cartilage may be transplanted from other joints using naturally absorbed pins.(4)(5)
How To Prevent The Formation Of Osteochondritis Dissecans?
It is never desirable to get injured while playing sports and lose the ability to play sports. Take the following precautions to prevent disruptive osteochondritis.
- Be sure to take proper rest during training and before and after the game.
- Do not repeat the same training and movements repeatedly.
- Muscles such as knees and elbows where the osteochondritis is common Training or stretching
- If you feel any discomfort, stop exercising immediately and consult a specialist.
In addition to the above, it is also recommended to use supporters and taping to reduce the burden.
- Pascual-Garrido C, Southworth TM, Slabaugh MA, et al. Osteochondritis Dissecans. 2019.
- Mohr B, Taylor RG, Baldea JD. Knee Osteochondritis Dissecans. StatPearls [Internet]: StatPearls Publishing; 2019.
- Gobbi A, Whyte GP. Osteochondritis dissecans: pathoanatomy, classification, and advances in biologic surgical treatment. Bio-orthopaedics: Springer; 2017:489-501.
- 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.