- Osteochondritis Dissecans is a poorly understood condition where a piece of hyaline cartilage and bone threatens to or becomes detached from the surface of the knee joint, usually from a femoral condyle. It is thought to occur during the transition from childhood to adolescence when the blood supply to the epiphyseal bone changes and a variable size of bone and overlying cartilage loses its blood supply.
- Surgery for Osteochondritis Dissecans is controversial. There is no evidence that any operations alter the natural history of the condition whilst symptoms are often not improved with surgery. However, some can benefit from removal of detached fragments, pinning of large fragments, drilling or cartilage regeneration.
Osteochondritis Dissecans
General information
Symptoms and signs
- Usually found incidentally on X-ray or MRI.
- Symptoms vary with some being asymptomatic (incidental finding) whilst others can cause usually poorly localised pain, limp and inability to do sports.
- The fragment may still be attached but may threaten to detach (fluid signal behind it on MRI) or may detach completely resulting in a loose body and possible locking.
Who to refer
- Because of the controversies of surgery, we are happy to see all newly diagnosed cases of Osteochondritis Dissecans to discuss treatment options and their limitations / controversies.
How to refer
- SCI Gateway/Orthopaedics/Knee
- If the patient is under the care of NHS Physiotherapy, investigations and onward referral to knee service, if appropriate, will be organised by Physiotherapy service without the need for further GP intervention.
Information to include when referring:
- Duration, any cause of symptoms
- Site/spread and if pain constant or intermittent, and/or walking at night
- Active and passive ROM
- Treatment to date