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OSTEOCHONDRITIS DISSECANS (MANAGEMENT (GOAL OF TREATMENT (Enhance the…
OSTEOCHONDRITIS DISSECANS
Definition
Osteochondritis dissecans is a joint disorder in which cracks form in the articular cartilage and the underlying subchondral bone.
Pathophysiology
Osteochondritis dissecans differs from "wear and tear" degenerative arthritis, which is primarily an articular surface problem. Instead, OCD is a problem of the bone underlying the cartilage, which may secondarily affect the articular cartilage. Left untreated, OCD can lead to the development of degenerative arthritis secondary to joint incongruity and abnormal wear patterns.
Clinical manifestations
Symptoms include joint pain
stiffness
even locking of the joint so that its range of motion is significantly limited to the point that it cannot be moved beyond a limited range.
CAUSES
ischemia (restriction of blood flow)
hereditary and endocrine factors
the causes remain unclear but include repetitive physical trauma
rapid growth, deficiencies and imbalances in the ratio of calcium to phosphorus
problems of bone formation.
avascular necrosis (loss of blood flow)
MANAGEMENT
Treatment options include modified activity with or without weight bearing
immobilization
cryotherapy
anti-inflammatory medication
drilling of subchondral bone
microfracture
removal or reattachment of loose bodies
mosaicplasty and osteoarticular transfer system (OATS) procedures.
GOAL OF TREATMENT
Enhance the healing potential of subchondral bone
Fix unstable fragments while maintaining joint congruity
Replace damaged bone and cartilage with implanted tissues or cells that can grow cartilage.
Non-surgical managment
Non-operative management may include activity modification, protected weight bearing (partial or non-weight bearing), and immobilization
The goal of non-operative intervention is to promote healing in the subchondral bone and prevent potential chondral collapse, subsequent fracture, and crater formation.
risk factors
Sports like Gymnastics, soccer, basketball, lacrosse, football, tennis, squash, baseball and weight lifting may put participants at higher risk of developing the condition.
Age: People between the ages of 10 and 20 are most commonly affected by osteochondritis dissecans
Sex: Male sex is twice or thrice more likely to develop the condition than female sex.
Certain case reports also suggest genetic predisposition. Some people may have a greater tendency to develop osteochondritis dissecans by virtue of their genetic makeup.