What is an osteochondral defect?

Osteochondral is the medical term for the cartilage of the bone. An osteochondral defect refers to a specific area of damage on the bone’s articular cartilage that involves the damage of both the cartilage and the underlying bone. Articular cartilage is the smooth, slippery substance that coats the ends of the bones in a joint and is often compared to the rubbery substance on the end of a chicken bone. When the articular cartilage becomes damaged and that damage affects the bone beneath its protective surface, it is called an osteochondral defect. The specialists at BICMD have extensive experience and training when it comes to treating osteochondral defects of the joint. They have an excellent track-record and are able to give excellent advice and a second opinion for the best method of treating articular cartilage and bone damage.

What causes an osteochondral defect?

Although the cause of an osteochondral defect is largely unknown, the prevailing thought among orthopedic specialists is that these defects can occur from a traumatic injury. Other theories blame the lack of blood supply to the affected area, others site heredity, direct compressive trauma or repetitive strain. The causes may vary but the damaging effects of an osteochondral defect are the same.

Is an osteochondral defect the same thing as arthritis?

In both arthritis and an osteochondral defect, the articular cartilage which protects the bone is worn away, torn, or damaged. There is a distinct difference however and the treatments are significantly different as well. The differences are as follows:

  • Osteochondral defect
    • Damage of the articular cartilage AND the underlying bone
    • The damaged bone can fracture or break off
    • Cartilage and bone can be repaired using special techniques
  • Arthritis
    • Damage of the articular cartilage, allowing the bones to rub together
    • The bone is worn down but does not fracture or break off
    • Cartilage is not commonly repairable
    • Arthritic bone cannot be grafted

Can all joints have an osteochondral defect?

Osteochondral defects can occur in any joint in the body but are most commonly seen in the knee and the ankle. The hip and elbow are not immune to osteochondral lesions and, in rare cases, a cyst can form, causing additional bone damage by making it more vulnerable to fracture.

What are the symptoms of an osteochondral defect?

Osteochondral defects are painful. The joint involved will usually have pain that worsens with activity. Other Symptoms include:

  • Swelling of the joint
  • Crepitus, or a cracking or “crunching” sound when moving the joint
  • Locking of the joint
  • Decreased range of motion
  • A limp that develops

How are osteochondral defects diagnosed?

The orthopedic specialist at BICMD prefer both an x-ray and an MRI when diagnosing an osteochondral defect. The joint in which the patient is experiencing pain may also determine which diagnostic test is needed. Most commonly, an MRI will show articular cartilage damage and the underlying bone can be evaluated. A patient’s clinical history, lifestyle and sports history will also be obtained to determine a proper diagnosis and to plan for treatment.

How are osteochondral defects treated?

Non-surgical treatment:

Patients who are not experiencing great amounts of pain and whose activities are not limited may be able to live with the symptoms of an osteochondral defect. Conservative treatments include NSAIDs (non-steroidal anti-inflammatory drugs), ice, rest, physical therapy and joint injections with steroids or platelet rich plasma.

Surgical treatment:

Patients who are experiencing pain, or worsening symptoms may require surgical intervention. Cartilage defects that are unable to heal can progress to a painful condition. Surgical treatments vary greatly and depend on the area, size of defect and the age and health of the patient. Surgical treatment can include one of the following:

  • Osteochondral allograft transfer and MACI
  • Chondroplasty
  • Microfracture

How long is the recovery from an osteochondral defect?

The recovery period for an osteochondral defect depends greatly upon the treatment. Non-surgical treatments that are effective in resolving pain can take 4-12 weeks. Larger defects that require surgery can take six months to a year to return completely to sport at pre-injury levels.

For more information about osteochondral defects or if you would like to be evaluated for your knee, ankle, elbow or shoulder pain, please click on “Connect With a Doctor” to reach one of our orthopedic telemedicine experts. Our second opinions are from expert physicians who are the top in the country for treating orthopedic injuries.