What is an Osteochondral Injury?
Where our bones (osteo) come together to make joints, we have a smooth white tissue called articular cartilage (chondro) that covers and protects the end of the bones from grinding against one another. When that end part of the bone or articular cartilage is damaged or detached, it is called an Osteochondral injury. These injuries typically occur at the knee, elbow, or ankle. The severity of the injury varies from small cracks in the bone to complete detachment and tearing. When the main cartilage along the joint, called Hyaline Cartilage, is damaged, the surface of the bone becomes rough. Pain ensues as the bones rub together. If left untreated, damaged cartilage can lead to arthritis.
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Osteochondral injuries most frequently occur in adolescents and young adults who are active in sports or other high levels of activity, but they can also occur just from normal wear and tear. Specialists suggest that osteochondral injuries are caused by multiple factors, including:
- direct trauma
- prolonged or repeated strain
- lack of blood supply to the specific area
How do you know if you have damaged cartilage? There are some clear symptoms that often accompany osteochondral injuries:
- Weight-bearing pain
- Joint instability
- Tender to the touch in certain areas
- Unable to reach full range of motion
- The joint sometimes locks or clicks
- Cartilage damage often accompanies ligament or meniscal tears
Treatment Option #1: Non-Surgery
The treatment goal when dealing with Osteochondral injuries is to restore cartilage to the damaged area and to help stimulate regrowth. If the cartilage is not completely torn or damaged, minimal treatment is advised. This includes icing the affected area and long periods of rest. This conservative way of treating the injury is also recommended for children whose bones are still growing.
Treatment Option #2: Osteochondral Surgery
If the above treatment does not work, if the cartilage is severely torn, or if the injury causes instability to the joint, then surgery may be needed. Most surgeries on Osteochondral injuries are done arthroscopically. The following are different surgical options to consider:
- Microfracture, Drilling, or Abrasion Arthroplasty—These options all refer to creating one hole or several tiny fractures in the joint in order to increase blood supply levels and stimulate healthy cartilage regrowth.
- Autologous Chondrocyte Implantation (ACI)—Taking healthy cartilage from one part of the body and implanting it into the affected area.
- Autograft Transplantation—Replacing the defective cartilage with healthy cartilage from the same joint. This is recommended for small injuries, as it necessitates that healthy cartilage be drawn from a limited area on the same joint.
- Allograft Transplantation—A tissue graft from a cadaver donor, recommended if the injury is too big for an autograft transplantation.
As is common after surgery, Osteochondral surgeries most likely will require that the patient continue his or her treatment by participating in physical therapy in order to help restore range of motion and stimulate cartilage regrowth. Sources: OrthoInfo and UWHealth.
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