Osteochondritis Dissecans

Osteochondritis Dissecans is a condition in which the cartilage in a specific area of the joint detaches due to loss of the blood circulation to the underlying bone. The cartilage that has broke loose may act as a loose body and cause clicking or locking symptom. Osteochondritis Dissecans commonly affects the femoral condyle causing knee pain, capitellum leading to elbow pain or talar dome resulting in ankle pain.  It is typically seen in children and adolescents.

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Causes

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Localized areas of cartilage loss happens due to loss of blood circulation to the underlying bone leading to detachment of the cartilage fragment. The precise reason for this is unknown. However, it is suspected to be due to anatomical variation in the blood vessel arrangement. 

 

Where does cartilage loss affect?

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The most common joint that gets affected is the knee. Elbow is the next common joint that gets affected. In the knee it is usually the medial femoral condyle (inner part of the joint at the end of the thigh bone). In the elbow, it affects the capitellum (the outer part of elbow at the end of the arm bone).

 

What happens if OCD is not treated?

 

The pain due to lack of cartilage support may persist. In the knee adjacent weight bearing area will see cartilage degeneration over a period of time. In addition to that the restricted of range of movement of the joint may persist. Repeated clicking or locking of the joint due to the loose fragment of cartilage getting caught in the middle of the joint is another issue which can keep bothering.

 

Management

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In patients with minimal pain and no locking symptoms, conservative management in the form of activity modification and avoiding overuse may help. However the youngsters with symptomatic OCD need chondroplasty. The cartilage resurfacing is often done by OATS (Osteochondral Autologous Transfer Surgery).