Osteochondritis dissecans is a disorder in which a piece of cartilage and subchondral bone separates from the surrounding bones to form a loose body. Fragments of cartilage cause pain and instability of the joint. The knee joint is most commonly affected. Other common sites include the elbow and ankle joint.
Osteochondritis dissecans affects young
people 10 to 20 years of age. Although it is only one
side that is affected, in some cases, it can affect both
The initial symptoms are mild pain after activity
Recurrence of swelling in the knee joint is due to the effusion of the other joints
Locking or giving way due to a loose body
Limited range of motion
Pain worsens with activity
The cause is unknown. It is thought that fragment separation occurs as a result of a decreased blood supply to the affected bone and cartilages. Repetitive trauma may contribute to the occurrence of ischemia or fragment separation.
The diagnosis is made by history, physical examination and an X-Ray test. X-Rays show a bony fragment with defects to the articular surface of the surrounding bones.
An MRI scan is useful in making a treatment decision, because it provides information about the articular surface, fragment location and size.
The treatment depends on the fragment location, size and age of the patients.
- Stable, small lesions are managed by activity modification and anti-inflammatory medications. The patient should avoid sports activities for 6 to 12 weeks.
- If the lesion is large or the segment is separated to form a loose body, surgical treatment is required.