Treatment Options for Osteochondritis Dissecans
Your physician may recommend various treatments depending on the diagnostic scans, age, severity, stability of the cartilage and other factors. Goals of treatment are to relieve the symptoms and stop or impede the progression of degeneration of the joint.
Non-surgical Treatment Options for Osteochondritis Dissecans
Conservative treatment approaches such as the wait-and-watch approach, pain medications and immobilization for 1-2 weeks are recommended if the condition is diagnosed at an early stage and if the severity is mild. However, surgery is required if the condition is diagnosed at an advanced stage or the condition is severe.
Surgery to Treat Osteochondritis Dissecans
Surgical correction of osteochondritis dissecans can be done using the open technique or arthroscopic technique. Some of the surgical procedures include:
- Drilling: In this method, multiple small holes are drilled into the bone to allow the growth of new blood vessels and the flow of blood in the defective area. This initiates the healing response and formation of new cartilage cells inside the lesion.
- Open reduction internal fixation: Open surgery is performed in cases where the defective area is difficult to reach with an arthroscope. Hence, an open incision may be required. In this procedure, an incision is made in front of the joint to allow your surgeon to view the joint, and the loose bodies are removed. Internal fixation involves fixing the fragments using internal fixators such as metal screws, pins or wires.
- Bone grafting: Grafting helps to fill the gap after removal of dead or necrotic bone. In this procedure, a bone graft is placed in the damaged site. This procedure may be performed to repair the damaged area or replace the missing bone. Autograft (harvested from your own body) or allograft (taken from a bone bank) may be required to help in the growth of new bone.
- Osteochondral grafting: The procedure involves transfer of healthy cartilage plugs from a non-weight-bearing area of the joint and transferring them to the damaged areas of the joint in a mosaic pattern. It allows the newly implanted bone and cartilage to grow in the defective area. Grafts may be taken from your own body (autograft), or a donor or bone bank (allograft).
- Autologous chondrocyte implantation (ACI): In this procedure, healthy cartilage cells are harvested from a non-weight-bearing joint and cultured in a laboratory. The cultured cartilage tissue patch will be implanted into the defective area to promote the growth of new cartilage.