Osteochondritis Dissecans

Osteochondritis Dissecans

Osteochondritis dissecans (os-tee-o-kon-DRY-tis DIS-uh-kanz) is a joint condition in which bone underneath the cartilage of a joint dies due to lack of blood flow. This bone and cartilage can then break loose, causing pain and possibly hindering joint motion.

Osteochondritis dissecans occurs most often in children and adolescents. It can cause symptoms either after an injury to a joint or after several months of activity, especially high-impact activity such as jumping and running, that affects the joint. The condition occurs most commonly in the knee, but also occurs in elbows, ankles and other joints.

 

Doctors stage osteochondritis dissecans according to the size of the injury, whether the fragment is partially or completely detached, and whether the fragment stays in place. If the loosened piece of cartilage and bone stays in place, you may have few or no symptoms. For young children whose bones are still developing, the injury might heal by itself.

Surgery might be necessary if the fragment comes loose and gets caught between the moving parts of your joint or if you have persistent pain.

Knee Osteochondritis Dissecans (OCD) Doctor in Pune, India

Symptoms

Depending on the joint that’s affected, signs and symptoms of osteochondritis dissecans might include:

  • Pain. This most common symptom of osteochondritis dissecans might be triggered by physical activity — walking up stairs, climbing a hill or playing sports.
  • Swelling and tenderness. The skin around your joint might be swollen and tender.
  • Joint popping or locking. Your joint might pop or stick in one position if a loose fragment gets caught between bones during movement.
  • Joint weakness. You might feel as though your joint is “giving way” or weakening.
  • Decreased range of motion. You might be unable to straighten the affected limb completely.

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Causes

The cause of osteochondritis dissecans is unknown. The reduced blood flow to the end of the affected bone might result from repetitive trauma — small, multiple episodes of minor, unrecognized injury that damage the bone. There might be a genetic component, making some people more inclined to develop the disorder.

Risk factors

Osteochondritis dissecans occurs most commonly in children and adolescents between the ages of 10 and 20 who are highly active in sports.

Nonsurgical Treatment

If symptoms do not subside after a reasonable amount of time, your doctor may recommend the use of crutches, or splinting or casting the affected arm, leg or other joint for a short period of time.

In general, most children start to feel better over a 2- to 4-month course of rest and nonsurgical treatment. They usually return to all activities as symptoms improve.

Surgical Treatment

Your doctor may recommend surgery if:

  • Nonsurgical treatment fails to relieve pain and swelling
  • The lesion is separated or detached from the surrounding bone and cartilage, moving around within the joint
  • The lesion is very large (greater than 1 centimeter in diameter), especially in older teens

There are different surgical techniques for treating OCD, depending upon the individual case.

  • Drilling into the lesion to create pathways for new blood vessels to nourish the affected area. This will encourage healing of the surrounding bone.
  • Holding the lesion in place with internal fixation (such as pins and screws).
  • Replacing the damaged area with a new piece of bone and cartilage (called a graft). This can help regenerate healthy bone and cartilage in the area damaged by OCD.

In general, crutches are required for about 6 weeks after surgical treatment, followed by a 2- to 4-month course of physical therapy to regain strength and motion in the affected joint.

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