Osteochondritis Dissecans

Osteochondritis dissecans is a joint condition when a fragment of the bone and cartilage separates from the rest of the bone due to the lack of blood supply. This fragment of the bone and cartilage can either break loose resulting in pain and possibly movement restriction or remain close to the area of detached, and does not present any symptoms. It may take several months or years for symptoms to develop, however, it is also possible that the fragment can stay in place and heal on its own.

Osteochondritis dissecans can happen in children, young youth or adults. Symptoms are usually more severe in adults when recovery is comparatively slower. This condition is more prevalent in the medial femoral condyle (knee), but also occurs in the capitulum of humerus (elbow) and talus (ankle).

Signs and Symptoms of Osteochondritis Dissecans

Depending on the level of damage, the signs and symptoms may vary from each individual, which includes:

• Weakness in the joint
• swelling, and soreness around the joint
• catching and locking of the joint in one position
• reduced range of movement in the joint
• clicking, cracking or popping sound when moving the joint
• pain and stiffness, often after physical activity
• stiffness in the joint after a period of inactivity

Causes of Osteochondritis Dissecans

The cause of this condition is not well known, but there are few explanations to it:

Repetitive trauma or stress to the bone or joint. High-impact activities such as running and jumping increase the risk of it.

Hereditary. A mutation in the gene which structures the cartilage produces fragile cartilage. Making it more prevalent in developing the disorder.

Ischemia. Reduced blood flow from vessels disease leading to bone necrosis (bone dead), which is usually a result from repetitive trauma

Treatment

Typically, ceasing high impact exercises and change of activity will ease the symptoms as healing occurs naturally. In some cases, the doctor may prescribe, crutches and splinting to reduce pressure onto the joint. However, surgery is sometimes required if conservative management fails or when the lesion is too big. The role of a physiotherapist is more significant post surgically, in order to address muscle imbalances, gait retraining and return to sports.