The term osteochondrosis dissecans is used in medicine to describe a bone disease. This can lead to bone decomposition or the formation of an unnaturally large layer of cartilage. Osteochondritis dissecans is manifested by severe pain and wear and tear. The term itself is actually already outdated. It is now referred to as an osteochondral lesion. In about 75 percent of all diseases, the knee is affected by osteochondrosis dissecans, but the ankle and hip can also be affected by the disease.
What is osteochondrosis dissecans?
Osteochondrosis dissecans is a degenerative disease of the bones of the ankle or knee joint. It manifests itself in severe pain in the joints, which worsens as the disease progresses. See theinternetfaqs for Atrial Septal Defect Basics.
The causes are very diverse, among other things, insufficient movement or incorrect strain can be the trigger. The development of osteochondritis dissecans is favored by risk factors such as being overweight and can be observed more frequently in advanced age.
It is no longer possible to reverse a change in bone substance that has already occurred. Therapeutic approaches only help to alleviate the symptoms.
Causes
In most cases, the cause of osteochondrosis dissecans is natural wear and tear, which occurs as the affected person ages. This is mainly due to the fact that at a young age, excessive or incorrect stress can often be compensated for.
As the body ages, bones, cartilage and muscles weaken. The result of this weakening is the detachment of small bone particles, which leads to increasing pain when moving. Long-term incorrect loading often increases the risk of developing osteochondritis dissecans.
Rheumatic diseases can also be a cause. Especially in the case of osteochondrosis dissecans, which occurs comparatively rarely, the body cannot convert its cartilage cells into bone material, so that the joints become heavily cartilage.
Symptoms, Ailments & Signs
Osteochondrosis dissecans occurs primarily in young people who are physically active. All joints can be affected. However, the disease is usually observed in the knee or ankle joints. As a rule, the disease process initially proceeds without symptoms. At this stage, osteochondritis dissecans can only be diagnosed as an incidental finding.
Later, in the eight to fifteen-year-old patients, the first load-dependent diffuse pain occurs, which cannot yet be localized. There is not yet a pain point that hurts to touch. Pain in the joints occurs regularly during sporting activities or other stress on the joints. When you rest, the symptoms go away again.
This is why joint pain in the morning does not usually occur. The symptoms only develop during the course of physical activity during the day. But there are also completely painless courses of the disease. However, the disease usually progresses until the joint mouse is eventually rejected.
Then suddenly very severe pain in the affected joints can occur. If stretching inhibitions and blockages occur in addition to the pain, there is a clear indication of osteochondritis dissecans, which is about to detach the joint mouse. But even with very clear findings for a dissection, in some cases a pain-free course of the disease can still occur.
Diagnosis & History
The typical symptoms of osteochondritis dissecans include above all joint and bone pain. It is only noticed by those affected themselves when inflammatory pain formation is already present.
In addition to a detailed discussion, the doctor will also take an X-ray to make the diagnosis. In most cases, this already provides information about whether and how severe the wear on the joints is. If the disease is still in an early stage, the doctor will probably not be able to make any reliable statements about possible changes. In this case, magnetic resonance imaging (MRI) is carried out to further confirm the diagnosis.
If osteochondrosis dissecans is not treated, the pain will become significantly worse as the disease progresses. Movement is restricted, which leads to a massive reduction in the patient’s quality of life.
Especially when children and adolescents show symptoms of osteochondrosis dissecans, these are often interpreted as growing pains or the consequences of an injury. Children and adolescents who are active in sports in particular always suffer from pain during and/or after physical activity, which is why the sport then has to be stopped.
↳ Further information: Home remedies for joint pain
Complications
In the case of osteochondritis dissecans, those affected primarily suffer from complaints in the bones. Broken bones also occur much more frequently as a result of illness and can significantly reduce the patient’s quality of life. Pain, which occurs primarily in the joints, occurs especially when there is stress.
However, many sufferers of osteochondrosis dissecans also suffer from rest pain, so that sleep problems and thus depression can occur, especially at night. It can also block scars, so patients can suffer from paralysis or other sensory disorders. The joints wear out relatively quickly and movement is restricted.
If osteochondritis dissecans occurs in children, growth disorders and thus delayed development can occur. The child may then no longer be able to play sports. The disease is treated without complications. The symptoms can be alleviated with the help of medication and various therapies. In some cases, however, patients are dependent on surgical interventions.
When should you go to the doctor?
If people who are active in sports experience problems with their bone structure, they should undergo a check-up. Professionals who have to do intense physical work and experience irregularities in their skeletal system should also consult a doctor. In most cases, the symptoms continuously increase in intensity and scope over the course of life. If there is a misalignment or incorrect posture of the body, the person concerned needs help. Corrections are needed to prevent the development of serious physical impairments that result in lifelong disabilities. Therefore, a doctor should be consulted in time and a treatment plan should be drawn up.
Joint pain, an unusual decrease in physical performance and low resilience should be discussed with a doctor. If additional emotional problems arise as a result of the physical losses, a doctor’s visit is necessary. A decrease in well-being, a reduced quality of life and behavioral problems should be discussed with a doctor.
If severe pain suddenly occurs, see a doctor as soon as possible. Pain medication should not be taken independently, as it can lead to complications and side effects. If everyday obligations can no longer be fulfilled as usual or without any symptoms, it is advisable to consult a doctor. In many cases, lifestyle habits must be restructured and movement sequences optimized in order for health to improve.
Treatment & Therapy
If osteochondrosis dissecans has been diagnosed, appropriate treatment is carried out. Because it is a degenerative disease, damage to bone tissue cannot be fully reversed. The treatment always depends on the relative size of the respective changes and the localization.
Early diagnosis is important for targeted treatment. First, the patient’s symptoms are treated. Conservative therapy should always be preferred first. Pain is relieved with appropriate medication. In addition to painkillers, the doctor can also use so-called muscle relaxants. The symptoms can also be alleviated by massage, heat or electrical stimulation applications. Physiotherapy can also provide relief.
If the osteochondritis dissecans is already in an advanced stage, a surgical intervention can also help. Hardened cartilage tissue is removed and – if necessary – a joint prosthesis is used. After the surgical procedure, excessive and incorrect loading should be avoided as completely as possible.
Outlook & Forecast
The outdated term osteochondritis dissecans describes an osteochondral lesion on joints under load. It is a joint disease that occurs in the knee joint, the ankle joint or the hip joint.
Left untreated, osteochondrosis dissecans causes osteoarthritis. The osteochondral lesion mainly affects young and middle-aged people who are athletic. Surgical measures can reduce the ankle or knee joint damage. Early surgery can often completely restore the former physical resilience.
However, in young patients under the age of twelve, the prognosis can be positive without surgery. Spontaneous healing occurs in half of the cases. Doctors are therefore waiting to see what develops in very young patients. An operation on the affected joint is only considered if self-healing is not evident. Otherwise, the prognosis is positive if the affected bone area can be revitalized by appropriate measures. As a result, the dissected material is not detached.
The prognosis is worse when other procedures are used. Attempts to attach the so-called bone mouse or to insert a cartilage transplant are usually less successful. Sensitive reactions are to be expected in the long term, especially in the joints of the lower extremities, if there are changes in the cartilage apparatus. These don’t even have to be serious.
Prevention
Osteochondroses dissecans can usually only be prevented to a limited extent. In general, a balanced diet rich in vitamin D is important. Sufficient exercise also strengthens the muscles, which in turn prevents wear and tear. With all movements, however, care should be taken to avoid incorrect and overloading of the joints.
If the pain occurs during physical activity, a consistent break or relief can help to reduce the symptoms. Mechanical symptoms such as blockages or restricted stretching are also a clear warning signal, because in this case there is usually already a change in the joint surfaces.
Under certain circumstances, taking part in a back school can help to find a permanently correct posture and thus prevent painful complaints from the outset.
Aftercare
In most cases, the patient with osteochondritis dissecans only has a few direct follow-up measures available. Ideally, the person affected by this disease should contact a doctor as soon as the first symptoms and signs of the disease appear, so that further symptoms and complications can be prevented. Self-healing is also not possible, so that medical help is usually necessary.
In most cases, those affected are dependent on the measures of physiotherapy or physiotherapy in order to relieve the symptoms properly and permanently. Many of the exercises can also be done at home to speed healing and improve body movement. However, in some cases, the disease must also be treated by surgery.
The person concerned should definitely rest after the procedure and take care of their body. You should refrain from exertion or from stressful and physical activities. The person affected may also be dependent on the help of their family in everyday life due to osteochondrosis dissecans. As a rule, however, the life expectancy of those affected does not decrease.
You can do that yourself
In addition to the medical treatment of osteochondritis dissecans, there are various options for self-help. There are different recommendations as to what load an affected joint should be exposed to.
The focus of therapeutic measures is on maintaining muscular balance and building muscle. However, it is important to focus the treatment on the individual course of the disease and the stage of the patient’s disease. Doctors and physical therapists can provide guidance on physical exercises that should be performed regularly at home. Maintaining or increasing performance can only be achieved through continuous repetition in conjunction with professional support.
In addition to active sporting activities, relaxation and stretching exercises can be carried out. Various options such as yoga or progressive muscle relaxation are taught in courses and are easy to integrate into everyday life. A few minutes of such exercises every day can help to improve the quality of life of the affected patient and show new ways of dealing with the symptoms.
Such measures can also include the social environment of the sick person, since, in contrast to medical therapy, they can also be carried out by healthy family members. This support can help people accept the condition and feel less left out.
