Goals of treatment are to relieve the symptoms and stop or impede the progression of degeneration of the joint. Your surgeons may recommend various treatments depending on the diagnostic scans, age, severity, stability of the cartilage and other factors. You may also have a CT or MRI scan that is useful in determining the location and stability of the lesion. Your surgeon will order an X-ray of the knee to see the abnormality in the joint space and to assess any displacement. Pain and swelling usually increases after activity. Patients with osteochondritis dissecans usually have joint pain, swelling, stiffness, decreased range of motion, and will often describe mechanical features such as ‘popping’ or ‘locking’. The appearance of osteochondritis dissecans in several family members may indicate that the condition is inherited. These changes, in addition to increased joint pressures, can cause failure of healing of the damaged area of joint surface. However, by this time, articular cartilage will be compressed, flattened, and a subchondral cyst (under the cartilage) may have developed. Following the injury or trauma, the bones in the area may be deprived of blood flow leading to necrosis (tissue death) and finally the bone fragment may become loose and break off. Osteochondritis dissecans may be caused by restricted blood flow to the bone-cartilage junction of the affected bone that usually occurs in conjunction with repetitive trauma. The exact cause for osteochondritis dissecans remains unknown and certain factors such as trauma, fractures, sprains, or injury to the joint are considered to increase the risk of developing the condition. Athletes participating in a variety of sports may develop osteochondritis dissecans. Osteochondritis dissecans is more common among boys and young men between 10 and 20 years who take part in sports. The condition can also occur in other joints, including your elbows, ankles, shoulders and hips. Osteochondritis dissecans occurs characteristically within the lateral aspect of the medial femoral condyle. Each knee has two femoral condyles, the medial femoral condyle on the inside of the knee and the lateral femoral condyle on the outside of the knee. The two femoral condyles make up the rounded end of femur (thigh bone). The knee, mostly the femoral condyles are most commonly affected. ![]() These fragments may be localized, or may detach and ‘dislodge’ into the joint space causing pain, locking and joint instability. ![]() The separated fragments are sometimes called “joint mice”. Osteochondritis dissecans is a condition in which a piece of cartilage, along with a thin layer of the bone separates from the end of the bone because of inadequate blood supply.
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