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Osteochondritis dissecans

Osteochondritis dissecans is when a loose piece of bone and cartilage separates from the end of the bone because of a loss of blood supply and insuffecient amounts of calcium. The loose piece may stay in place or slide around making the joint stiff and unstable. Osteochondritis Dissecans most commonly effects the knees or ankles. If a serious injury occurs in this area, the bone around it will supply it with as much calcium as possible to try and fix the loose piece of bone. This often results in a calcium build up around the loose piece. This build up is surgically removed most of the time. more...

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This is a minor disease, however it is very rare. It commonly occurs in boys and young men from 10-20 years of age while they are still growing. As girls become more active in sports, it is becoming more common among them as well.

Diagnosis

To determine whether your pains are Osteochondritis Dissecans, you can have an MRI to show whether the loose piece of bone is still in place. In specific cases if caught early enough, a harmless dye will be injected into your blood stream to show where the calcium will most likely continue to build up. Doing this makes the removal process much easier.

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Treatment of chondral lesions in advanced stage of osteochondritis dissecans - a comparative study of chondrocytes, mesenchymal stem cells and periosreal
From Journal of Bone and Joint Surgery, 1/1/03 by P, Hui James H

Introduction: (OCD) is characterized by bone necrosis and softening of the overlying cartilage, which may separate and displace. It is thought to he secondary to trauma, ischaemia or abnormal epiphyseal ossification. Management remains controversial during the early stages of the disease. Surgery for advanced chondral lesions with loose bodies however remains a challenge. Options that include periosteal graft and autologous chondrocyte transplantation have been used with variable degrees of success. This study investigates the efficacy of these techniques and the use of mesenchymal stem cells to treat advanced chondral lesions found in OCD in animal models.

Materials and Methods: A full thickness articular cartilage defect (6mm long, 3mm wide and 1mm deep) was created in the weight-bearing surface of medial femoral condyle in 22-week old NZW rabbits. A total of 90 knees were randomly divided into 3 groups as follows: 1) Transfer of cultured chondrocytes 2) Transfer of cultured periosteum-derived MSCs and 3) Repair by periosteal graft with their contralateral knees as control. The rabbits were allowed to move freely in their cages. The rabbits were sacrificed at 2, 6, 12, 24 and 36 weeks post-operatively. The healing of the defects was assessed by gross examination and histological grading and subjected biomechanical testing.

Results: Gross and histological examination at 36 weeks post operation (Wakitani et al grading), the mean score for Group 1 is 2.5, Group 2 is 2.3 and Group 3 is 4.5 with control group of 8.9 in terms of cell morphology, matrix staining, surface regularity, thickness of repaired cartilage and integration of cartilage to adjacent host. Biomechanically by indentation test, Group1 had value of 0.22 MPa, Group 2 0.20 MPa, Group 3 0.16 MPa and Control group of 0.12 MPa.

Conclusion: The findings suggested that cultured chondrocytes and mesenchymal stem cells had comparable enhancing effect of the repair of chondral detect in advanced OCD

Hui, James H P, F Chen, SW Chong, S Nathan and E H Lee

Department of Orthopaedic Surgery, National University of Singapore, Singapore.

Copyright British Editorial Society of Bone & Joint Surgery 2003
Provided by ProQuest Information and Learning Company. All rights Reserved

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