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Osteochondritis dissecans is a disorder associated with osteoarthritis or necrosis of the joints. In the course of this disease, as a result of weaker blood supply or complete lack of vascularization of a bone fragment, it dies. This becomes the starting point for the development of degenerative changes in the joint.
People with separating necrosis complain mainly of pain in the affected joints, muscle atrophy and weakness of the affected limbs. The most common disorders are the knee joints, humerus and ankle joint.
What causes necrosis?
Great importance in the etiology of separating necrosis is attributed to joint overload, injuries – single, larger or smaller, but repeated, and vasomotor disorders. There are also theories that the causes of aseptic necrosis in adults should be found in developmental disorders consisting in the production of separate points of ossification separated from the bone epiphyses by a thin cartilage coat.
What is the treatment like?
There are two forms of separating necrosis: the typical adult form and the young type. The latter is usually associated with a better prognosis. In young people with an immature skeletal system, conservative treatment usually allows up to 50% of patients to be cured. However, it takes a long time to recover from full fitness, from 10 to 18 months. Conservative treatment consists of relieving the limb (but not immobilizing it), using painkillers and non-steroidal anti-inflammatory drugs. If this does not work, surgery is required. Arthroscopy is the treatment of choice. During the procedure, the place of necrosis is drilled and cleaned, and the bone fragment is stabilized. Chondrocyte (cartilage cells) transplants into necrotic sites are also performed.
Text: lek. med. Matylda Mazur