What You Need to Know Osteochondritis dissecans is a bone and cartilage condition that most often occurs in the knee. Osteochondral grafting is a method of treating such conditions of cartilage damage where the underlying bone is exposed. Occasionally a nuclear medicine bone scan is used to assess the degree of loosening within the joint. Osteochondral fracture of the lateral femoral condyle is a rare intra‐articular injury with or without patellar dislocation. 1 The knee joint is perhaps one of the busiest joints in the body as it bears most of the body weight when standing. When there is a break, tear, separation, or disruption of the cartilage that could be referred to as an osteochondral lesion. Osteochondral Defect is the name given to a condition most noticeable in the knee, in which a part of the bone and cartilage gets separated from the knee joint resulting in chronic pain in the knee and difficulties performing normal activities of daily living. Osteochondritis dissecans is an idiopathic disease which affects the subchondral bone and its overlying articular cartilage due to loss of blood flow. Osteochondritis dissecans (OCD) is a problem that affects the knee, mostly at the end of the big bone of the thigh (the femur). This approach allows planning an appropriate course of treatment. 59 years experience Internal Medicine. Dec 3, 2020. Patient- and lesion-specific factors must be identified when evaluating a patient with an articular cartilage defect. This bone and cartilage can then break loose, causing pain and possibly hindering joint motion.Osteochondritis dissecans occurs most often in children and adolescents. To diagnose osteochondritis dissecans, an X-ray, CT scan or MRI scan can be performed to show necrosis of subchondral bone, formation of loose fragments, or both. As a result, the small piece of bone and the cartilage covering it … Figure 2. Patients typically present with chronic ankle pain and swelling, and some have mechanical symptoms. A joint surface damaged by OCD doesn’t heal naturally. Regardless, each osteochondritis dissecans lesion must be followed until osseous integration is confirmed by imaging -otherwise, progression of disease to osteoarthritis is likely.” Most osteochondral defects are caused by one of two events: Wear and tear over time; Injury from sports or physical activity: Injuries usually occur with a combination of twisting force and direct impact that damages the cartilage. The knee joint, ankle joint, and elbow joint are common … Treatment of chondral and osteochondral lesions of the patellofemoral (PF) joint is complex as it typically must address the multifactorial etiology. Figure 1. Osteochondral lesions of the talus (OLT) are those that affect the chondral and subchondral areas of the talus. knee). Introduction: Spectrum of disease entities from single, focal defects to advanced degenerative disease of articular (hyaline) cartilage; Epidemiology. This kind of disease is commonly seen in the knee joint sprain during strenuous activity. A major symptom of this condition is severe knee pain. If there is damage to the articulating structures of the knee, you will know it. Large, focal articular cartilage defects of the knee (> 4 cm) can be a source of significant morbidity and often require surgical intervention. The exact incidence and prevalence within … The use of fairly large osteochondral plugs appears to correlate with retro-patellar crepitus and increased scintigraphic activity, and is not therefore recommended. MRI shows an osteochondral loose body and unstable osteochondritis dessicans lesion on the medial femoral condyle with underlying signal intensity (Figure 2). 5-10% of people > 40 years old have high grade chondral lesions; location. The condition happens most often in … A chondral defect refers to a focal area of damage to the articular cartilage (the cartilage that lines the end of the bones). It usually occurs in the knee, ankle or elbow. Osteochondral allografts (Cadaver grafts) have been used to treat large talar lesions with some success. Osteochondral defects (OCDs), often used interchangeably with osteochondritis dissecans in the juvenile population, are focal areas of articular cartilage wear/damage resulting in a loss of cartilage and inflammation of the adjacent subchondral bone (Juneau et al., 2016; Modarresi & Jude, 2015; Wheeless, 2012). It’s most common in children and teens who are active in sports. Even with surgery, OCD usually leads to future joint problems, including osteoarthritis. Osteochondral Allograft Transfer (i.e., Cadaver): A bone and cartilage plug may also be obtained from a cadaver and transplanted into the OLT. An osteochondral defect refers to a focal area of damage that involves both the cartilage and a piece of underlying bone. The most commonly affected joint is the knee, with the majority of lesions located in the femoral condyle and/or patellofemoral articulation (Wheeless, 2012). [] This is a broad terminology that encompasses a variety of disorders including osteochondritis dissecans, osteochondral fractures, and osteochondral defects. Dr. Veena Govila answered. At present, open reduction is often used to treat osteochondral fractures. It has no known cause, but repetitive stress on the joint, low vitamin D and a genetic predisposition are often linked to this condition. A 16-year-old male asked: i am 16 y/o and i had been having pain in my knee(for 4-5 years).my report says osteochondral defect with a loose body. Osteochondral defects in the knee are due to lesions of the cartilage and bone. An Osteochondral lesion is an injury to the articular cartilage and the bone beneath it. Treatment may include activity modification, drilling, fixation, or osteochondral replacement of osteochondritis dissecans lesions in the knee. This may result in separation and instability of a segment of cartilage and free movement of these osteochondral fragments within the joint space.That process can lead to pain, loose body formation and joint effusion. It occurs when a small segment of bone begins to separate from its surrounding region due to a lack of blood supply. Actual surgical treatments for osteochondral lesions and early knee osteoarthritis seem to be promising. Several pathologic conditions may manifest as an osteochondral lesion of the knee at MRI and cause diagnostic difficulties, including acute and traumatic osteochondral injuries, subchondral insufficiency fracture of the knee, avascular necrosis, osteochondritis dissecans, and localized degenerative lesions; the typical patient demographics, clinical presentation, etiologic role of trauma, and pertinent MRI … They typically are associated with a history of trauma; however, nontraumatic etiologies have been described. Many of the worst ligament and cartilage injuries in professional sports are considered severe osteochondral defects. See: - Knee Joint Menu: - Arthroscopy of the Degenerative Knee - Osteochondritis Dessicans - Osteoarthritis - Discussion: - described types articular cartilage lesions; - mild lesion, w/ normal appearing cartilage - it is difficult to dissern borders of lesion and normal surrounding cartilage. 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