Osteochondritis dissecans

Most consider this disease due to traumatic osteochondral fracture or repeated minor trauma causing blood supply disturbance and osteochondral necrosis and separation; some propose bacterial emboli or fat embolism of terminal arteries and family heredity. The fragment includes cartilage and underlying bone; it may attach to the parent bone by a fibrous pedicle or be free. The separated surfaces are covered by fibrous tissue or fibrocartilage with some new bone; a fully loose body grows by absorbing synovial fluid. Loose bodies vary in size and number and may cause joint locking; pedicle rupture causes intra-articular hematoma, and joint wear causes hypertrophic arthritis.

Common Symptoms

Second costal cartilage pain; muscle atrophy

Causes

Direct trauma separates bone and cartilage fragments; traumatic osteochondral fracture or repeated minor trauma causes blood supply disturbance and osteochondral necrosis and separation. Frequent continuous trauma causes irreparable bone and cartilage damage, leading to degeneration, peeling or loose bodies. Thrombosis or other pathology interrupts local blood supply, causing regional bone necrosis, with dead bone and overlying articular cartilage separating from healthy bone. Enneking found few anastomoses of terminal subchondral arteries. Endocrine disturbance, heredity, epiphyseal artery embolism and infection may also be related. Pathologically the main feature is intra-articular osteochondral damage, clinically showing osteochondral peeling and the loose cartilage falling into the joint to form a loose body (or half-loose), impairing joint function.

Treatment

Supportive treatment, rehabilitation therapy

Prevention

No effective prevention; after surgery the knee should be flexed 30 degrees and fixed for at least 6 weeks; during immobilization perform isometric quadriceps exercises, and after removal, mobilize early to restore limb function quickly.

Recommended Department

It is recommended to visit the orthopedic surgery department; before the visit you may first book an appointment and connect with experts through this platform.

Warm reminder: The above information is provided for health education reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek care at a regular hospital in time.