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Osteochondritis dissecans

Osteochondritis dissecans is the term used to describe bone necrosis of a certain part of a joint surface, usually caused by trauma, and can be accompanied by detachment of a joint surface fragment. All joints of the human body can be affected, although the knee joint is most frequently affected during the growth phase. Micro- or macrotraumas often lead to a subchondral vascularization disorder in the affected bone area.

Depending on the stage of the disease, the damaged cartilage-bone fragment can detach from the joint surface as a dissect (so-called joint mouse) and leave a defect site (so-called mouse bed).

Diagnosis and treatment

Our 17-year-old patient had fallen on her right knee joint five weeks previously and had been in severe pain ever since. An initial examination was carried out in hospital and rest was prescribed for 4 weeks. At the initial presentation in our surgery, a recent MRI scan showed a significant deterioration compared to the previous findings. The patient had stage 3 osteochondritis dissecans of the medial femoral condyle on the right, i.e. a detached, free joint body measuring 3x2cm in the weight-bearing zone. The patient underwent prompt surgical treatment, the cartilage-bone fragment was freshened and refixed. This reconstructed the physiological shape of the knee joint and restored adequate functionality and fitness for sport, especially given the patient’s young age.

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