11/25/2023 0 Comments Bone fragments in knee![]() What are the surgical treatment options for osteochondritis dissecans? These patients need surgery at the time of diagnosis. Unlike children, adults with osteochondritis dissecans do not have a potential for spontaneous healing. a: MRI’s at initial presentation b: Healing without problem at 2 years. This is followed arthroscopic or open treatment of the disease.įigure 3 a,b: Healing of osteochondritis dissecans in a child before the end of adolescence. Advanced imaging methods such as computed tomography (CT) and magnetic resonance imaging (MRI) are needed for determining the stage of the disease, planning surgery and analyzing treatment outcomes (Figure 2) Arthroscopic examination is an essential part of the diagnosis, the joint is visualized using a 5 mm camera and the size, location, stability and suitability for repair of the fragment is determined. Osteochondritis dissecans can be diagnosed with a careful physical exam followed by plain X-rays in the majority of the patients (Figure 1). How is Osteochondritis dissecans diagnosed? If the fragment has separated and a loose body is present, mechanical symptoms such as catching and locking may occur, some patients may feel the fragment moving around the joint. This pain increases with sports and activity and decreases with rest. The main symptom of osteochondritis dissecans is pain. What are the symptoms of Osteochondritis dissecans? However, the symptom severity and disease progression may not be the same if both knees are affected, one knee may progress to healing while the other knee may require surgery. It is more common in boys and both knees may be affected in 15-30% of the children. Less frequently, hip and elbow joints are affected. Osteochondritis dissecans is most commonly seen in the knee and ankle joints. Where does Osteochondritis dissecans occur? Most of the adult patients presenting with osteochondritis are untreated or unrecognized cases that manifest symptoms when the fragment separates from the underlying bone. Osteochondritis dissecans is usually seen in children before adolescence. However, this fragment separates from the bone and becomes a freely moving loose body in the joint unless treated or healing occurs spontaneously in children. In the early stages of the disease, the fragment lies in a crater in the surrounding bone, with weak soft tissue attachments and an intact cartilage. The cartilage covering the fragment is still viable since it receives its nutrients from the joint fluid, while the bone below the cartilage is dead. Osteochondritis dissecans is a disease in which a small fragment of bone adjacent to the cartilage in the knee joint separates from the surrounding bone due to a local problem in blood supply.
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