What is an osteochondral injury to the knee?

There are two ridges at the end of the femur. On the surface of these ridges, called the inner condyle and the outer condyle, there is cartilage.

With insufficient blood supply, part of the surface of the bone beneath the cartilage in the condyles (eighty-five percent of the internal condyle) of the thigh dies.

Following the death of the bone, the adjacent cartilaginous layer between the thigh and the tibia is also destroyed, and thus the patient feels pain and dryness due to the degeneration of the condyle of the thigh on the upper plate of the tibia. Knee joint cramps occur during knee movements. This condition is accompanied by a sound and a feeling of tightness in the knee joint during knee movements. This complication is called osteochondral injury or osteochondral defect or Osteochondritis dissecans.

What is an osteochondral injury to the knee? Our doctors will answer this question below

 

 

What is Osteochondritis dissecans?

It is a rare disorder in which part of the bone beneath the cartilage dies due to insufficient blood supply. This complication may occur in the following areas:

• Two-thirds of cases of osteochondral injuries occur in the knee, and up to 85 percent of these cases involve the inner bulge of the end of the femur (inner condyle).
• In the ankle joint (upper level of the talus bone)
• Sometimes in the elbow joint (capitulum joint surface)

Osteochondral injuries can be bilateral in 20 to 30% of cases.

 

Distribution and prevalence of osteochondritis dissecans or ocd epidemiology

• Most OCDs are made without a family history
• Per 100,000 people, usually fifteen to twenty-nine people suffer from osteochondritis dissecans.
• Children aged eight to ten years and adults from ten to twenty years are more likely to suffer from this complication
• This condition is especially common in athletes and young people with a lot of physical activity
• People with this complication seem to be more prone to osteochondritis (inflammation of the bones and joints), both themselves and their family members, and experience this complication at a younger age.

 

What are the causes of OCD?

We said that reduced blood supply to the bone beneath the cartilage causes bone death and the destruction of the adjacent cartilage plate. The following factors can cause this condition:

• Gentle and continuous traumas
• Severe direct traumas
• Unknown injuries

Perhaps the presence of a genetic component predisposes people to osteochondral knee injury

 

Symptoms of osteochondral knee injury

Symptoms of OCD include:

• Joint pain
• Weakness or joint swelling

These symptoms are usually caused by an exercise or knee movement.

• A person with knee OCD cannot fully open or bend the knee as before, in other words, the range of motion of the knee will be reduced.
• The person suffers from dryness after resting in the knee movement
• Lock the knee
• Hear the click of the knee when moving the joint.

 

How is knee osteochondral injury diagnosed?

Your doctor will evaluate the stability of the joint by performing a knee joint examination, and in addition to a thorough clinical examination, he or she may request the following diagnostic tests depending on your condition.

• X-ray photo:

This method can show the bone and show the damaged part of the bone and its size limits. A white area in the bone under the cartilage is an image that provides a simple radiographic image on the OCD.

• Knee MRI can show the following well

Damaged cartilage

In case of bone and cartilage displacement, it well indicates the movement of these parts into the joint space.

• CT Scan

The condition of the bones, etc. are well displayed in this method

Definitive diagnosis of knee osteochondral injury with MRI

On examination of a person with osteochondritis dissecans of the knee with a more common involvement of the internal condyle of the lower thigh, the physician finds that the patient tends to rotate the affected leg further outward to relieve pressure from the inside of the knee.

During the examination, the doctor bends the knee and if pressure is applied to the injured part, the patient will suffer from pain.

Sometimes a radioisotope scan is also used to detect OCD

 

Treatment of knee disc osteochondritis

Despite non-surgical treatments (more effective in children); in some cases, treatment is only possible with surgery.

• Non-surgical Treatments
• It is mostly done in children and only in cases where the damaged part has not been moved.
• All sports should be discontinued.
• Interrupt all knee movements that cause pain.
• Sometimes it is necessary to immobilize the knee for one to two months by using a cast or brace.
• Sometimes it is necessary for the patient to use a crutch for a while.
• The person should not press the affected foot to the ground.
• After a while, at the doctor’s discretion, stretching exercises should be started under the supervision of a physiotherapist.

Sometimes it takes one to one and a half years to fully heal. During this time, the doctor monitors the condition of the knee with continuous imaging.

 

Surgical treatment

Surgery is needed in most adults and people who have had a damaged part removed.

Surgery can be done by splitting the skin or closed surgery with an arthroscope.

Whatever the surgery, your surgeon’s goal will be to place the damaged and displaced part in its original location.

The following techniques will be used by your surgeon when, due to the passage of time, both the location of the part is displaced and the part itself is deformed a lot.

• Drilling bone
• Allograft bone graft
• Osteochondral autograft
• Autograft chondrocyte implantation

 

What is the prognosis of osteochondral knee injury?

The following factors affect the patient’s prognosis:

• Patient age
• Injury size
• Injured area
• Displacement or non-displacement of the damaged part

In patients who are young and the damaged part is not displaced or has a slight displacement, the treatment results are good.

In people with high displacement of the damaged part, the results are usually not satisfactory.

 

The final words

In the end, we have to say that the symptoms of OCD are very vague in the beginning, and for this reason, it is diagnosed late. Sometimes, the affected person has only a slight decrease in the range of motion of the knee.

The most important symptom of a knee OCD is dull and vague knee pain, so if you have mild symptoms, it is best to be examined by a doctor.