Effects of Knee Injury

Osteochondritis Dissecans - What Is Osteochondritis Dissecans?

Osteochondritis dissecans results from a loss of the blood supply to an area of bone underneath a joint surface and usually involves the knee. The affected bone and its covering of cartilage gradually loosen and cause pain. A person with this disruption of the joint may eventually develop osteoarthritis. This disorder usually arises spontaneously in an active adolescent or a young adult. It may be due to a slight blockage of a small artery or to an unrecognized injury or tiny fracture that damages the overlying cartilage.

The bone undergoes avascular necrosis (degeneration from lack of a blood supply). 2 The involvement of several joints or the appearance of osteochondritis dissecans in several family members may indicate that the disorder is inherited.

What Are the Symptoms of Osteochondritis Dissecans? How Is It Diagnosed?

If spontaneous healing doesn't occur, cartilage eventually separates from the diseased bone and a fragment breaks loose into the knee joint, causing locking of the joint, weakness, and sharp pain. An x ray, MRI, or arthroscopy can determine the condition of the cartilage and be used to diagnose osteochondritis dissecans.

How Is Osteochondritis Dissecans Treated?

If cartilage fragments have not broken loose, a surgeon may fix them in place with pins or screws that are sunk into the cartilage to stimulate a new blood supply. If fragments are loose, the surgeon may scrape down the cavity to reach fresh bone and add a bone graft and fix the fragments in position. Fragments that cannot be mended are removed, and the cavity is drilled or scraped to stimulate new growth of cartilage. Research is currently being done to assess the use of cartilage cell transplants and other tissues to treat this disorder.

Plica Syndrome

Plica (pronounced PLI-KAH) syndrome occurs when plicae (bands of remnant synovial tissue) are irritated by overuse or injury. Synovial plicae are remnants of tissue pouches found in the early stages of fetal development. As the fetus develops, these pouches normally combine to form one large synovial cavity. If this process is incomplete, plicae remain as four folds or bands of synovial tissue within the knee. Injury, chronic overuse, or inflammatory conditions are associated with development of this syndrome.

What Are the Symptoms of Plica Syndrome? How Is It Diagnosed?

People with this syndrome are likely to experience pain and swelling, a clicking sensation, and locking and weakness of the knee. Because the symptoms are similar to symptoms of some other knee problems, plica syndrome is often misdiagnosed. Diagnosis usually depends on the exclusion of other conditions that cause similar symptoms.

How Is Plica Syndrome Treated?

The goal of treatment is to reduce inflammation of the synovium and thickening of the plicae. The doctor usually prescribes medicine such as ibuprofen to reduce inflammation. The patient is also advised to reduce activity, apply ice and compression wraps (elastic bandage) to the knee, and do strengthening exercises. If this treatment program fails to relieve symptoms within 3 months, the doctor may recommend arthroscopic or open surgery to remove the plicae. A cortisone injection into the region of the plica folds helps about half of the patients treated. The doctor can also use arthroscopy to confirm the diagnosis and treat the problem.