Osteochondritis Dissecans: A Practical Orthopaedic Overview

A local area of bone beneath cartilage can lose strength or normal support. The overlying cartilage may remain attached and stable, or it may become damaged and separate. The knee is a common site, but other joints can be involved. Age, skeletal maturity, lesion location, imaging appearance, and mechanical symptoms all influence management.

Pain with loading, swelling, stiffness, catching, and locking are useful details to report. Knee locking can indicate a mechanical problem but is not specific to this condition. A clinician combines the history and physical examination with imaging rather than diagnosing from a symptom or scan phrase alone.

Begin with an assessment that identifies the joint involved and checks whether the lesion is stable. Until then, modify painful impact, jumping, twisting, or deep bending. Keep a record of swelling, catching, and activities that change symptoms.

For a stable lesion, care may include protected activity, symptom control, and physiotherapy to maintain movement and develop strength without overloading the joint. An unstable lesion, persistent mechanical symptoms, or a damaged cartilage surface may prompt discussion of cartilage repair surgery. Follow-up imaging may help show whether the area is changing.

Seek an orthopaedic appointment for ongoing joint pain, repeated swelling, loss of movement, or symptoms that interfere with sport, work, or daily tasks. Get prompt help if the joint locks, cannot support your weight, becomes suddenly swollen, or appears deformed after an injury.

Ask whether the lesion is stable, what the imaging shows about the cartilage, how long activity should be modified, what physiotherapy goals apply, and which changes would make cartilage repair surgery appropriate.