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Treatments and drugs
By Mayo Clinic staffTreatment of osteochondritis dissecans is intended to restore the normal functioning of the affected joint and to relieve pain, as well as reduce the risk of osteoarthritis. No single treatment, however, is effective for everybody.
Conservative measures
Initially, your doctor will likely recommend conservative measures, which are effective in most cases. They may include:
- Resting your joint. Refrain from impact activities such as jumping and from cut-pivot activities in which you can put strain on your knee as you rotate the joint. If your injury is due to a throwing sport, you'll be instructed to refrain from throwing.
- Immobilizing your joint. This may involve using a hinged brace or crutches if your knee or ankle is affected.
- Using nonsteroidal anti-inflammatory medications. These include aspirin, ibuprofen (Advil, Motrin, others) and naproxen sodium (Aleve, Naprosyn).
- Avoiding competitive sports and intense physical activity. These activities may put a strain on your affected joint and cause pain. Resting for at least six to eight weeks and limiting competitive activity helps ease signs and symptoms for most people.
- Physical therapy. Most often, this therapy includes stretching and range-of-motion exercises, and strengthening exercises for the muscles that support the involved joint. Low-impact aerobic conditioning, such as use of a stationary bicycle, helps to maintain cardiovascular fitness.
When surgery is an option
Although most people see improvement with conservative measures, surgery is an option when problems persist for at least three months, the joint motion is blocked and other treatment options haven't helped.
Surgery called arthroscopy is minimally invasive. It begins when your surgeon inserts a thin scope into the joint space to visualize the area on a television monitor. The surgeon then determines the location of the damage and decides upon the best type of surgical procedure.
Tiny surgical instruments are inserted into small incisions, and loose bone fragments may be reattached or removed. When cartilage fragments are still attached to the bone, they can be tightly secured with pins or screws. The goal of this surgery is to restore normal blood flow and improve joint function.
Physical therapy after surgery is necessary to optimize strength, stability and function.
Although most people with osteochondritis dissecans are free of symptoms after appropriate treatment, doctors may recommend restrictions on daily activities to help reduce the risk of recurrence. For example, while young athletes may be able to return to playing sports, doctors may ask that they limit participation initially to light workouts, and then gradually work back into competition after completing sport-specific conditioning exercises.
