How to Treat Osteochondritis

Osteochondritis dissecans (OCD) is a term for any osteochondral fracture in which a bone or cartilage fragment becomes loose within a joint. The underlying bone in Osteochondritis dissecans has normal vascularity, which distinguishes this condition from osteonecrosis.

Instructions

• 1

  Use conservative measures primarily on patients with immature skeletons. These patients may benefit from limitation of weight-bearing activity if their radiographs do not show loose bodies. Immobilizers are frequently helpful in reducing the stress to affected knees.

• 2

  Make a preoperative evaluation for adult patients. A Magnetic Resonance Imaging (MRI) scan should be done to determine the size of the lesion and arthroscopy may also provide diagnostic information.

• 3

  Consider surgical options for osteochondritis. There are a number of arthroscopic procedures available including debridement and stabilization, or excision, curettage and drilling. Lesions larger than 3 cm typically require open removal of the loose bodies and reconstruction.

• 4

  Perform surgery to treat the lesions. Arthroscopic surgery will involve making multiple perforations with Kirschner wires. A bioresorbable nail may be necessary to hold smaller bone fragment in place while a nonabsorbable screw may be needed with larger lesions. An open removal will require Kirschner wires to keep the fragment in place.

• 5

  Follow the proper post-operative procedures. Arthroscopic surgery will require immobilization of the joint with a motion-restricting brace until signs of healing are evident. Administer passive motion for two days beginning on the day of surgery, and then begin rehabilitation exercises for at least six weeks. The patient should progress to full weight bearing within eight weeks.