Osteochondritis Dissecans

ExitCare ImageOsteochondritis dissecans occurs when a piece of the joint (articular) cartilage, that covers the ends of long bones, is separated from the bone. This cartilage protects the bones, and allows joints to move smoothly, without pain. Osteochondritis dissecans can occur to the cartilage of any joint. However, it is most common in the knee, ankle, and elbow.

SYMPTOMS

  • Swelling, pain (often comes and goes), aching, giving way, and locking or catching of joints.

  • Feeling a loose fragment in the joint.

  • Tendency to walk with the foot of the affected leg pointed outward, in cases involving the knee.

  • Crackling sound (crepitation) within the joint, with motion.

  • Often, no symptoms. (Condition is diagnosed when x-rays are taken for other reasons).

CAUSES

There is no known cause for osteochondritis. However, many factors may affect the chances of injury, such as direct hit (trauma), repeated stress, or the loss of blood supply.

RISK INCREASES WITH:

  • Sports involving repeated force (distance running, playing sports year-round).

  • Obesity.

  • Family history of the condition.

  • Posture problems, such as bow legs or knock knees.

  • Other joints affected with osteochondritis dissecans.

PREVENTION

There are no known preventative measures.

RELATED COMPLICATIONS

  • Frequently recurring symptoms, resulting in chronic pain and swelling.

  • Arthritis of the affected joint.

  • Loose fragments, with locking of the affected joint.

TREATMENT

Treatment first involves ice and medicine, to reduce pain and inflammation. Osteochodritis dessicans has the best results if treatment occurs before the injured person reaches adult skeletal maturity. For less severe cases, in which the cartilage is damaged but left intact, treatment often involves restraint followed by strength and stretching exercises. If the patient is skeletally mature, or if the cartilage has detached from the bone, surgery may be needed to reattach or remove the loose fragments. After surgery, strength and stretching exercises are advised to regain strength and a full range of motions. Exercises can be performed at home or with a therapist.

MEDICATION

  • If pain medicine is needed, nonsteroidal anti-inflammatory medicines (aspirin and ibuprofen), or other minor pain relievers (acetaminophen), are often advised.

  • Do not take pain medicine for 7 days before surgery.

  • Prescription pain relievers may be used as needed. Use only as directed and only as much as you need.

HEAT AND COLD

  • Cold treatment (icing) should be applied for 10 to 15 minutes every 2 to 3 hours for inflammation and pain, and immediately after activity that aggravates your symptoms. Use ice packs or an ice massage.

  • Heat treatment may be used before performing stretching and strengthening activities prescribed by your caregiver, physical therapist, or athletic trainer. Use a heat pack or a warm water soak.

SEEK MEDICAL CARE IF:

  • Symptoms get worse or do not improve in 2 weeks, despite treatment.

  • Any of the following occur after surgery:

  • You develop signs of infection: fever, increased pain, swelling, redness, drainage of fluids, or bleeding in the affected area.

  • You experience pain, numbness, or coldness in the foot (after surgery on the knee or ankle).

  • Blue, gray, or dark color appears in the toenails (after surgery on the knee or ankle).

  • New, unexplained symptoms develop. (Drugs used in treatment may produce side effects.)