Osteochondritis Dissecans is a bone condition that affects the joints, usually in children and teenagers. The bone beneath the joint cartilage dies off when it is deprived of blood flow. At some point, both the cartilage and bone can break loose, and this causes significant pain and may even hinder movement in the joint. The disorder typically appears in the knees after a joint injury or after many months of high-impact activity like running and jumping, although it can be present in any joint.
Osteochondritis dissecans is staged based on injury size, if the fragment is completely or partly detached, and if the loosened cartilage remains in place. The exact cause of the condition is not known, although it is thought that a genetic component or repeated stress may be involved. Those who encounter the injury as children may face an increased chance of eventually developing osteoarthritis in the affected joint.
In cases where the cartilage fragment stays in place, patients may see no symptoms. Otherwise, they are likely to experience:
The cause of osteochondritis dissecans is not known. Despite being discovered over 100 years ago, osteochondritis dissecans is a rare condition, and therefore researchers have not been able to collect enough data to develop an understanding of it.
Scientists have developed some theories, however. Osteochondritis dissecans was originally considered to be a non-traumatic disorder – that is, not caused by an acute injury to the joint. But some have suggested that repetitive strain might play a role in the development of osteochondritis dissecans. Some studies have found that 50%-60% of people with the disorder play sports or engage in some other strenuous athletic activity. But although repetitive strain is currently the most accepted cause of osteochondritis dissecans, the evidence is still limited and more studies are needed.
Some researchers have suggested there may be a genetic component to osteochondritis dissecans. However, one study found that only 1.2% of people with a first degree relative with osteochondritis dissecans develop it themselves.
Inflammation has also been suggested as a potential cause, however this has not been demonstrated in the evidence available to date.
Adolescents who participate in organized sports can utilize proper protective gear as well as practicing stability and strength training to reduce their chances of developing the injury in the first place. When osteocondritis dissecans does occur, many will benefit from frequent rest and activity modification to promote healing.
For some, this could mean taking a break from participating in their sport. Braces and crutches may be needed, and NSAIDs will assist in managing the pain. Various exercises and stretches can also be helpful. Young children may see the injury heal on its own as their bones continue to grow. If all other options are ineffective, surgery might be required.
There are no established ways of preventing osteochondritis dissecans. It appears that most people who develop the condition regularly engage in sports. This may imply that avoiding repetitive strain to the joints may reduce the risk of osteochondritis dissecans.
However, the vast majority of people who engage in sporting activities do not develop osteochondritis dissecans. This suggests that sporting activity is not enough by itself to cause the disease, and there must be other environmental or biological risk factors at play. These risk factors may make some people more susceptible to developing the condition than others. However, these risk factors are not known, and until they are discovered it is not possible for doctors to make preventive recommendations.