The 26 Review
- What is Cartilage Damage (OCD) OsteoChondritis Dissecans is a condition where a fragment of bone and cartilage are damaged.
- Causes Occurs after an injury, such as a sprain or trauma to the foot and ankle
- Symptoms Stiffness, pain, swelling, and difficulty bearing weight on the foot and ankle
- Diagnosis Physical examination, X-ray, MRI, or CT scan
- Treatment Physical therapy, activity modification, bracing, corticosteroid injections, anti-inflammatory medications, and surgery
Let’s take a closer look…
Osteochondritis dissecans is a common condition that takes place in the joint when a lack of blood to the joint causes the bone inside to soften. Typically occurring after an injury such as an ankle sprain, a small piece of the bone dies and separates from the larger bone. This small piece of bone, along with the cartilage, can then crack and break loose. The loose bone and cartilage may remain in place, but it can also move into the joint area, causing the joint to become unsteady. Osteochondritis dissecans can leave a lesion where the cartilage and bone separate. This whole process can take months or years, so symptoms may take a long time to appear. Typically, this condition affects the knee, ankle, and elbow.
Causes of osteochondritis dissecans include a traumatic injury or repeated trauma or stress to a joint over time. This repeated stress or trauma can be brought on by playing sports or engaging in intense physical activity.
Depending on the severity of the condition, some individuals may experience no symptoms. If symptoms do exist, they can include the following:
- Pain, swelling, and/or weakness in the joint, especially after physical activity
- Decreased range of motion. This is more likely to happen if the detached cartilage and bone drift into the joint space
- Stiffness in the joint after resting
- Locking or sticking of the joint in one position
- A clicking or popping sound when moving said joint
To diagnose osteochondritis dissecans, the medical professional will begin by performing a physical examination and assess the joint’s stability. For further clarity, the doctor may order a few tests. Those tests include an X-ray, MRI, Ultrasound, and CT scan. Each test performs different things, but generally provides high performance imaging to locate the lesion and its size, as well as show if the bone and cartilage have detached and where they’ve gone.
The treatment options for someone struggling with osteochondritis dissecans depends upon the severity of the injury. To begin, the medical professional will suggest more conservative therapies, including, physical therapy, anti-inflammatory medication, corticosteroid injections, and activity modifications with a brace. If the conservative treatments fail to alleviate symptoms, 1 of 3 surgeries may be recommended. The recommended surgery will depend on the stage and size of the injury. The first type is called an osteochondral autograft transfer. An OAT surgery encompasses a transfer of cartilage from one part of the joint to another. They’ll take healthy cartilage from an area of the bone that is non-weight bearing and then match the graft to the surface area of the defect. The second type of surgery is called an osteochondral allograft transplantation. An allograft is a tissue graft received from a cadaver donor. The block of bone and cartilage will be shaped to fit into the exact contour of the defect and then pressed into place. The third surgery involves debriding out the damaged cartilage and drilling the defect to facilitate localized bleeding in the area. This option works best for smaller cartilage defects. To determine the right treatment plan for yourself, seek guidance from a licensed podiatrist.