Osteochondrosis dissecans

With the term Osteochondrosis dissecans a bone disease is described in medicine. This can lead to decomposition of the bones or the formation of an unnaturally large layer of cartilage. Osteochondrosis dissecans is manifested by severe pain and causes of wear and tear. The term itself is actually already out of date. Meanwhile one Osteochondral lesion spoken. The knee is affected by osteochondrosis dissecans in around 75 percent of all diseases, but the ankle and hip can also be stressed by the disease.

What is Osteochondrosis Dissecans?

Osteochondrosis dissecans is a degenerative disease of the bones of the ankle or knee joint. It manifests itself as severe pain in the joints, which gets worse as the disease progresses.

The causes are very diverse, among other things, insufficient movement or incorrect strain can be the trigger. The development of osteochondrosis dissecans is favored by risk factors such as obesity and is more common in old age.

It is no longer possible to reverse a change in the bone substance that has already occurred. Therapeutic approaches only help relieve symptoms.

causes

In most cases, the cause of osteochondrosis dissecans is natural wear and tear, which occurs as the person concerned ages. This is mainly due to the fact that excessive or incorrect stress can often still be balanced out at a young age.

As the body ages, bones, cartilage and muscles are weakened. The result of this weakening is the detachment of small bone particles, which leads to increased pain when moving. Long-term improper stress often increases the risk of developing osteochondrosis dissecans.

Rheumatic diseases can also be a possible cause. Especially with osteochondrosis dissecans, which occurs comparatively rarely, the body cannot convert its cartilage cells into bone material, so that the joints become heavily cartilaginous.

Symptoms, ailments & signs

Osteochondrosis dissecans occurs mainly in young people who are active in sport. All joints can be affected. Usually, however, the disease is observed in the knee or ankle joints. As a rule, the disease process initially runs without symptoms. At this stage, osteochondrosis dissecans can only be diagnosed as an incidental finding.

Later, the eight to fifteen year old patients experience the first diffuse pain that is stress-dependent and cannot yet be localized. There is still no pain point that hurts to touch. The pain in the joints occurs regularly during sporting activities or other stresses on the joints. The complaints also go away in peace.

This is why morning joint pain usually does not occur. The symptoms develop during physical activity only during the day. But there are also completely painless courses of illness. However, the disease usually progresses until the joint mouse is finally rejected.

Then suddenly very severe pain can occur in the affected joints. If, in addition to the pain, there are additional stretch inhibitions and blockages, there is clear evidence of osteochondrosis dissecans, which is about to detach the joint mouse. But even with very clear findings in favor of a dissection, in some cases the disease progresses painlessly.

Diagnosis & course

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pain The typical symptoms of osteochondrosis dissecans include pain in the joints and bones. It will only be noticed by the person concerned if there is already inflammatory pain.

In addition to a detailed discussion, the doctor will also take an X-ray to establish the diagnosis. In most cases, this already gives information about whether and how severe the wear and tear on the joints is. If the disease is still at an early stage, the doctor will probably not be able to make any reliable statements about possible changes. In this case, magnetic resonance imaging (MRI) is performed to further confirm the diagnosis.

If the osteochondrosis dissecans is not treated, the pain will become significantly more severe as the disease progresses. Movement restrictions occur, which lead to a massive reduction in the patient's quality of life.

Especially when children and adolescents show symptoms of osteochondrosis dissecans, these are often interpreted as growing pains or the consequences of an injury. Children and adolescents who are active in sport always suffer from pain during and / or after a sporting activity, which is why sport must then be stopped.

Complications

With osteochondrosis dissecans, those affected primarily suffer from bone complaints. Bone fractures are also much more common due to illness and can significantly reduce the patient's quality of life. Pain occurs particularly when it is exerted, and it occurs primarily in the joints.

However, many people affected by osteochondrosis dissecans also suffer from pain at rest, so that sleep problems and thus depression can occur, especially at night. Furthermore, it can also block scars, so that patients can suffer from paralysis or other sensitivity disorders. The joints wear out relatively quickly and there are restrictions in movement.

Should osteochondrosis dissecans occur in children, growth disorders and thus delayed development can occur. The child may then no longer be able to do sports. The disease is treated without complications. With the help of drugs and various therapies, the symptoms can be alleviated. In some cases, however, patients are also dependent on surgical interventions.

When should you go to the doctor?

If physically active people experience bone problems, they should undergo a check-up. Working people who have to do intensive physical work and experience irregularities in their skeletal system should also consult a doctor. Most of the time, the symptoms continuously increase in intensity and scope over the course of life. If it comes to malpositions or a bad posture of the body, the person concerned needs help. Corrections are necessary so that no serious physical impairments develop that lead to lifelong restrictions. Therefore, a doctor should be consulted in good time and a treatment plan should be drawn up.

Pain in the joints, an unusual decrease in physical performance and a low level of resilience should be discussed with a doctor. If there are additional emotional problems due to the physical loss, a doctor's visit is required. A decrease in well-being, a reduced quality of life and behavioral problems should be discussed with a doctor.

If you suddenly experience severe pain, see a doctor as soon as possible. Pain medication should not be taken on your own responsibility, as it can lead to complications and sequelae. If the day-to-day obligations can no longer be fulfilled as usual or free of symptoms, it is advisable to consult a doctor. In many cases a restructuring of the lifestyle as well as an optimization of the movement sequences must take place, so that an improvement of the health occurs.

Treatment & Therapy

If osteochondrosis dissecans is diagnosed, appropriate treatment is given. Since it is a degenerative disease, the damage to the bone tissue can no longer be completely reversed. The treatment always depends on the relative size of the changes and the location.

Early diagnosis is important for targeted treatment. First, the person's symptoms are treated. First of all, conservative therapy should always be preferred. Pain relief is achieved with appropriate medication. In addition to pain relievers, the doctor can also use so-called muscle relaxants. The symptoms can also be alleviated by massages, heat or stimulation current applications. Physiotherapy can also provide relief.

If the osteochondrosis dissecans is already at an advanced stage, surgery can also help. Hardened cartilage tissue is removed and - if necessary - a joint prosthesis is inserted. After the surgical procedure, excessive and incorrect loading should be avoided as completely as possible.

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Outlook & forecast

The outdated term osteochondrosis dissecans describes an osteochondral lesion on stressed joints. It is a joint disease that is present in the knee joint, the ankle joint or the hip joint.

If left untreated, osteochondrosis dissecans causes osteoarthritis. The osteochondral lesion primarily affects young and middle-aged athletes. Surgical measures can reduce the ankle or knee joint damage. Often, with an early operation, the previous athletic resilience can be completely restored.

However, the prognosis can - in young patients under the age of twelve - be positive without surgery. In half of the cases, healing occurs spontaneously. Doctors are therefore waiting to see what develops in very young patients. An operation on the affected joint is only considered if self-healing is not evident. Otherwise, the prognosis is positive if the affected bone area can be revitalized through appropriate measures. This prevents the dissecate from coming off.

The prognosis is worse when other procedures are used. Attempts to attach the so-called bone mouse or to insert a cartilage transplant are usually less successful. In the long term, sensitive reactions are to be expected, especially in the joints of the lower extremities, if changes in the cartilage system occur. These don't even have to be serious.

prevention

Osteochondroses dissecans can usually only be prevented to a limited extent. In general, a balanced diet rich in vitamin D is important. Sufficient exercise also strengthens the muscles, which in turn prevents wear and tear. With all movements, however, care should be taken to avoid incorrect and overloading of the joints.

If the pain occurs during exercise, a consistent break or relief can help to alleviate the symptoms. Mechanical symptoms such as blockages or extension inhibitions are also a clear warning signal, because in this case there is usually a change in the joint surfaces.

Under certain circumstances, attending a back school can help to find a permanently correct posture and thus prevent painful complaints from the outset.

Aftercare

In most cases of osteochondrosis dissecans, the patient has only a few direct follow-up measures available. The person affected should ideally contact a doctor at the first symptoms and signs of the disease so that further complaints and complications can be prevented. It also cannot heal independently, so medical help is usually necessary.

In most cases, those affected are dependent on the measures of physiotherapy or physiotherapy to relieve the symptoms correctly and permanently. Many of the exercises can also be done in your own home to speed healing and improve body movement. However, in some cases the disease must be treated with surgery.

The affected person should definitely rest after the procedure and take care of his body. Exertion or stressful and physical activities should be avoided. The affected person may also be dependent on the help of his family in everyday life due to the osteochondrosis dissecans. As a rule, however, the life expectancy of the sick person does not decrease.

You can do that yourself

In addition to the medical treatment of osteochondrosis dissecans, there are various possibilities for self-help. There are different recommendations as to what kind of load an affected joint should be exposed to.

The focus of therapeutic measures is on maintaining muscular balance and building muscles. However, it is important to focus the treatment on the individual course of the disease and the stage of the patient's disease. Doctors and physical therapists can provide instructions on physical exercises that should be done regularly at home. Maintenance or an increase in performance can only be achieved through continuous repetition in connection with professional support.

In addition to active sporting activities, relaxation and stretching exercises can be performed. Various options such as yoga or progressive muscle relaxation are taught in courses and are easy to integrate into everyday life. A few minutes of such exercises a day can help improve the quality of life of the affected patient and open up new ways to deal with the symptoms.

Such measures can also include the social environment of the sick person, since, in contrast to medical therapy, they can also be carried out by healthy family members. This support can help sufferers accept the illness and feel less excluded.