Treatment of osteochondritis dissecans is intended to restore the normal functioning of the affected joint and to relieve pain, as well as reduce the risk of osteoarthritis. No single treatment works for everybody. In children whose bones are still growing, the bone defect may heal with a period of rest and protection.
Initially, your doctor will likely recommend conservative measures, which may include:
- Resting your joint. Avoid activities that put stress on your joint, such as jumping and running. You may need to use crutches for a time, especially if pain causes you to limp. Your doctor may also suggest wearing a brace to immobilize the knee for a few weeks.
- Physical therapy. Most often, this therapy includes stretching and range-of-motion exercises, and strengthening exercises for the muscles that support the involved joint. Physical therapy is commonly recommended after surgery too.
If conservative treatments don't help after three to six months, you may need surgery to remove loose fragments or to reattach fragments to the bone. Depending on the size of the fragment, or the tiny fractures in the bone underlying the fragment, surgery may be used to try to fill in the defect with cartilage containing bundles of collagen fibers (fibrocartilage). In many cases, these procedures can be performed arthroscopically — by inserting a fiber-optic camera and surgical tools through small incisions around the joint.
The newest procedure uses the person's own bone marrow to help rebuild the damaged area in the knee. New tissue quickly begins to grow to fill in the space where the bone fragment was removed.
Sep. 21, 2012
- Skinner HB, ed. Current Diagnosis & Treatment in Orthopedics. 4th ed. New York, N.Y.: The McGraw-Hill Companies; 2006. http://www.accessmedicine.com/content.aspx?aID=2315794. Accessed Aug. 4, 2012.
- Chambers HG, et al. American Academy of Orthopaedic Surgeons clinical practice guideline on: The diagnosis and treatment of osteochondritic dissecans. Rosemont, Ill.: American Academy of Orthopaedic Surgeons. http://www.aaos.org/research/guidelines/OCDGuideline.asp. Accessed Aug. 3, 2012.
- Moktassi A, et al. Imaging of osteochondritis dissecans. Orthopedic Clinics of North America. 2012;43:201.
- Greiwe RM, et al. Pediatric sports elbow injuries. Clinics in Sports Medicine. 2010;29:677.
- Knee problems. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Knee_Problems/default.asp#15. Accessed Aug. 4, 2012.
- Vannini F, et al. "One step" treatment of juvenile osteochondritis dissecans in the knee: Clinical results and T2 mapping characterization. Orthopedic Clinics of North America. 2012;43:237.
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