Osteochondritis Dissecans of the Knee
Original Editors - Tania Appelmans
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Definition[edit | edit source]
Osteochondral injury or condition affecting an articular surface that involves separation of a segment of cartilage and subchondral bone [2].[edit | edit source]
Clinically Relevant Anatomy [edit | edit source]
The femoral condyles, lateral and medial, form the rounded end of the femur. The tibial plateau, which articulates with the femoral condyles, is the upper side of the tibia. The articular bones are covered by white, shiny and elastic cartilage. The smooth articular surface of the femur roll and slide on the tibia plateau. Synovial fluid nourishes and lubricates the cartilage [1].[edit | edit source]
Epidemiology /Etiology[edit | edit source]
Osteochondritis dissecans is an injury of the cartilage of the synovial joint [2]. It can arise as a result of a direct trauma; when the articular cartilage is damaged due, for instance a fall, twist, sprain or tackle [5]. The tibial plateau could damage one of the condyles of the femur (85% on the medial condyle) [4]. Other possible etiologies are chemical changes at the surface located in the subchondral bone, genetic conditions, hereditary factors, ischemia, etc. [2,8].
There are four distinct stages of OCD [1,3,8]:
Stage one: ischemic osteonecrose begin to arise in a part of the subchondral bone, because the tissue is not well vascularized.
Stage two: a subchondral osteonecrose.
Stage three: partially detached lesions, a dissecans ‘in situ’.
Stage four: ‘Dissecans’, this is the loose of the affected bone fragment and the corresponding cartilage of the articular surface. This fragment falls between the moving parts of the knee joint and blocks it. A ‘joint mouse’ is the bone fragment that roams in the joint, because it moves and it is white [5].
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