Knee Osteochondritis Dissecans (Fracture) Lesion Proven Facts

I help athletes and people to recover from  Osteochondritis dissecans so that they can increase their sports abilities while decreasing pain and clicking in the knee.

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Don’t even think about trying to get any treatment unless you have read these facts about Osteochondritis dissecans.

Here are the proven methods to get back into running and sports faster and stronger after Osteochondritis dissecans lesion treatment, even if you now have pain, clicking, or locking in the knee.

• Do you feel grinding \ pain \ loss of confidence \ locking \ clicking in your knee?
• Are you not able to enjoy your daily living, running, dancing, trekking, sports because your knee is troubling you? 
• Is your weight increasing because you are not able to do exercises because of your knee Osteochondritis dissecans?

We Have Solution for Your Problems

After seeing your MRI films & doing knee examination, Dr. Manu Bora will advise you on the best treatment according to your injury.

1. Percutaneous Osteochondritis Dissecans Repair

80% of Osteochondritis dissecans can be healed without surgery. Our goal is to heal your cartilage Osteochondritis dissecans lesion as is very important for the prevention of knee osteoarthritis. The percutaneous Osteochondritis dissecans repair procedure is for individuals who may be considering surgery due to small and acute OC lesions. Orthobiologics treatments use your body’s own healing agents to regrow and repair damage to the cartilage and subchondral bone by concentrating and focusing them at the exact site of your injury. This approach allows for natural, efficacious healing without the need for surgery.

2. OATS (osteochondral autograft transfer system) Procedure

The osteochondral autograft transfer system is ideal for patients with 1 to 4 cm of osteochondritis dissecans lesion. In the OATS procedure, a round osteochondral fragment from a non-weight-bearing area of the knee is taken out and it is transferred to an Osteochondritis dissecans lesion in the weight-bearing area of the knee to restore the damaged articular surface. For less than 1 centimeter of osteochondritis dissecans lesion, a single plug autographed is preferred. For 2 to 4 cm of osteochondritis dissecans lesion OATS mosaicplasty is done with multiple smaller Autograft plugs.  OATS procedure is a single-stage arthroscopic keyhole surgery with minimal morbidity and quick recovery. Patients get back into sports within 3 months of the surgery.

3. Autologous Chondrocyte Implantation

Autologous chondrocyte implantation is ideal for larger osteochondral lesions between 4 to 10 cm. Autologous chondrocyte implantation is a two-stage arthroscopic procedure. In the first stage arthroscopy, healthy cartilage cells are taken from the non-weight bearing area of the knee and sent to the lab to regrow in-vitro over 4 to 6 weeks. After 4 to 6 weeks the second stage procedure is planned,  arthroscopic debridement of the lesion is done, and damaged cartilaginous and subchondral bone tissue is removed. All the saline is removed from the joint and dry arthroscopy is done. A periosteal patch or a synthetic collagen graft is taken and placed over the defect and sutured at the Periphery of the defect. The cultured cell is mixed with the fibrin and thrombin glue to make it sticky and it is filled in the defect and left for a few minutes so that it sticks to the bone. If the defect is more than 10 millimeters deep then bone grafting can be done before this.

Bone Marrow Aspirate Concentrate (BMCA)with Fibrin Glue

This is a SINGLE STAGE arthroscopic procedure. Arthroscopic debridement of the lesion is done and damaged cartilaginous and subchondral bone tissue is removed, microfracture is done at the base of the lesion.  All the saline is removed from the joint and dry arthroscopy is done. The Bone marrow aspirate concentrate {BMCA} is mixed with the fibrin and thrombin glue to make it sticky and it is filled in the defect and left for a few minutes so that it sticks to the bone. If the defect is more than 10 millimeters deep then bone grafting can be done before this. The remaining bone marrow aspirate concentrate is injected into the joint to enhance the healing process. 

Internal Fixation

High-grade osteochondral defect lesions with the loose bodies and articular flap generally don’t respond to the conservative treatment.  Partially detached lesions and loose bodies containing sufficient subchondral bone are arthroscopically reattached with the help of headless Titanium variable pitch compression screws and biodegradable k-wires.

Before reattaching the osteochondral fragments, the bed is prepared by micro-drilling and any fibrous tissue is removed by the arthroscopic Shaver to enhance the union. Because of the advancement in the implant system like headless compression screws and biodegradable k-wires implant removal is not necessary after the surgery as it does not irritate the tibial cartilage.

What will happen if you don’t take any treatment for your OC lesion?

•  Smaller lesions can be healed without surgery with a percutaneous Osteochondritis dissecans repair and It will increase in size if you don’t take any treatment for these lesions and then you will require surgery.
•  Bigger costochondritis dissecans lesions will increase in size and damage your knee cartilage and secondary knee osteoarthritis will develop if not treated. This will lead to severe knee degeneration and the patient will require knee replacement surgery in the future. 

Get back into sports faster & stronger to win the game and get medals.