Osteochondritis Dissecans is a disease or injury to the articular cartilage (lining of the end of the bone) and the subchondral (bone beneath the articular cartilage) bone. This occurs in the elbow, ankle and most commonly in the knee.
This may occur in childhood caused by hereditary reasons or trauma. It also occurs in adulthood and the cause it typically trauma or vascular, where the circulation to viable structures is compromised. If untreated this may progress to osteoarthritis. The progression of the damage begins with softening of the articular cartilage and eventual detachment. Often, the cartilage detaches with a piece of the subchondral bone.
Patients present with deep vague pain in the knee. If the cartilage detached then patients may experience locking or buckling of the knee. Recurrent swelling is also common.
A diagnosis is made with a physical exam, x-rays and an MRI.
Treatment for children may involve crutches and non-weightbearing if the damaged piece is stable and not detached. If the piece is unstable and still viable then the piece can often be repaired back on to the bone via a knee arthroscopy. If the piece is not viable and detached then a drilling or micro fracture procedure via an arthroscopy can be performed to stimulate production of a cartilage like scab over the exposed bone.
See also ARTICULAR CARTILAGE DAMAGE.