As a result of lack of blood supply, osteochondritis dissecans occurs in the joint when a piece of bone and cartilage separates from the rest. This causes pain, swelling, and reduced joint movement. Although osteochondritis dissecans can affect any joint, it is most prevalent in the knee, elbow, and ankle. Children and adolescents are more likely to develop the condition, especially those who are active in sports. Depending on the severity and location of the lesion, osteochondritis dissecans can be treated conservatively or surgically. It can also be prevented by avoiding excessive stress on the joints and following a healthy lifestyle.
Osteochondritis dissecans is believed to be caused by reduced blood flow to the bone. This can result from:
Traumatic or repetitive stress to the joint, such as from sports, injuries, or overuse
A genetic factor, such as defects in the structure or metabolism of the bone or cartilage
Puberty hormones, such as growth spurts or imbalances
Inflammatory or infectious diseases, such as osteomyelitis or rheumatoid arthritis
Osteochondritis dissecans can be caused by a number of factors, including:
Children and adolescents between the ages of 10 and 20 are more likely to suffer from this condition as their bones are still growing and developing
The condition is more common in males than females, as males tend to be physically active and have larger bones.
Those who participate in high-impact or repetitive sports, such as soccer, basketball, baseball, or gymnastics, are more likely to develop the condition.
In joints with curved or irregular shapes, such as the knee, elbow, or ankle, the condition is more common
According to the size, location, and stage of the lesion, osteochondritis dissecans may cause the following symptoms:
Joint pain or discomfort, especially after or during activity
Joint swelling or inflammation, which may be red or warm
Joint stiffness or reduced range of motion, which may limit certain movements or activities
A popping, clicking, or locking sensation in the joint may indicate that a loose piece of bone or cartilage is interfering with the normal functioning of the joint
Joint instability or weakness that may cause the joint to collapse or give way
Based on a medical history, physical examination, and imaging tests, osteochondritis dissecans can be diagnosed. The doctor will ask about the symptoms, the onset and duration of the symptoms, the medical history, and the level of activity of the patient. In addition, the doctor will conduct a physical examination that will include:
Checking the joint for swelling, redness, or tenderness
Feeling for any bumps, lumps, or crepitus in the joint
Examining the joint for pain, stiffness, or reduced range of motion
Stability and strength testing of joints
Some imaging tests may also be ordered by the doctor, such as:
The X-ray shows the bone structure and any abnormalities in the joint, such as fractures, dislocations, and lesions
A magnetic resonance imaging (MRI) scan can reveal soft tissues and any damage or inflammation in bones, cartilage, ligaments, or tendons
Cross-sectional images of the joint and any complications can be obtained from a CT scan
In arthroscopy, a small camera and instruments are inserted through small incisions into the joint, allowing the doctor to examine and treat the joint directly
Osteochondritis dissecans is treated based on age, health, and preferences of the patient, as well as the size, location, and stage of the lesion.
Non-surgical conservative treatment methods include:
Activity modification, such as avoiding or limiting the activities that cause or worsen the pain, such as running, jumping, and twisting
To reduce swelling and pain, apply a cold pack or frozen peas to the joint for 15 to 20 minutes, several times a day, and elevate it above the heart level.
Pain and inflammation can be relieved with medications, such as anti-inflammatory drugs, analgesics, or corticosteroids, that are available over-the-counter or by prescription
With physical therapy, you learn specific exercises and techniques to strengthen the muscles and tendons around the joint and to improve joint mobility and stability.
Wearing a cast or brace immobilizes or supports the joint, allowing the bones and cartilage to heal
Treatments involving invasive methods, such as:
Drilling or microfracturing the bone to stimulate blood flow and healing
In fixation, bone and cartilage are secured to the underlying bone with screws, pins, or wires
The process of debridement involves removing damaged or dead tissue from the joint
A graft is a transplant of healthy bone and cartilage from another part of the body or from a donor
A osteotomy involves cutting and reshaping the bone to improve joint alignment and function
Some measures can be taken to reduce the risk or severity of osteochondritis dissecans, such as:
Preparing the muscles and tendons for stress and preventing injuries and strains by warming up and cooling down before and after physical activity
Maintaining flexibility and elasticity of the muscles and tendons around the joints by stretching regularly
Limiting the frequency, intensity, and duration of activities that involve the joint, such as running, jumping, or twisting, to prevent overuse or excessive stress on the joint
Wearing appropriate equipment and techniques, such as shoes, pads, and helmets, and following the instructions and guidance of a coach or trainer, to prevent joint injuries
To allow the muscles and tendons to recover and heal from fatigue and stress, take breaks and rest
To support bone growth and cartilage health, eat a balanced diet rich in calcium and vitamin D
