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As an ex professional sportsman who has a PhD in knee ligament research, Chinmay Gupte is a complex knee specialist with a national and international pedigree in treating knee conditions.
Wellington Hospital, London, 15 - 17 Lodge Rd, London NW8 7JA
Mon - Fri 8:00 - 17:30
Osteochondral injury London refers to a type of joint injury that involves damage to the cartilage and underlying bone. The chondral cartilage is a smooth, rubbery tissue that lines the ends of bones where they meet to form a joint. It provides a cushion between the bones and allows for smooth movement of the joint. The chondral cartilage is not to be confused with the meniscus cartilage of the knee.
MRI scan of normal knee
An osteochondral injury can occur due to a traumatic injury, such as a fall or a direct blow to the joint, a repetitive stress injury, or it may develop over time due to wear and tear on the joint. The exact cause of OCD is not fully understood, but it is thought to be a combination of genetic, environmental, and mechanical factors. Certain sports that place repetitive stress on the joints, such as gymnastics, football, or basketball, have been linked to an increased risk of developing OCD. Other factors include:
The symptoms of an osteochondral injury can include:
The most reliable test in confirming the presence of an osteochondral injury is an MRI scan.
MRI scan of osteochondral injury of the thigh bone (femoral trochlea):
Treatment for an osteochondral injury will depend on many factors:
Mild injuries may be treated with rest from impact activity, and physiotherapy. Healing can take 6-12 months and is usually confirmed with a MRI scans 3-9 months later.
More severe injuries that are not healing or loose may require surgery.
Which type of surgery depends on size and location of defect.
Different options include:
Most injuries can be treated with keyhole arthroscopy. Some large defects or those in the kneecap area may require an open procedure with a 3-5cm incision.
Example of drilling of defect:
Example of MRI scan after bone fixed back into position with absorbable screws:
Example of bone fixed back with metal screws.
Defect fixed back into position with metal screws:
Most patients may need to use crutches without putting weight through the knee and a brace. This can be the case for between four and eight weeks.
Afterwards there are different phases of rehabilitation:
Most patients require MRI scans between four and eight months after surgery.
Once full healing takes place (this can take 8-18 months), the success of return to full activities is 95%. A small proportion of patients may have a recurrent injury after return to play or an injury in another area, but the vast majority have full healing and return to sport with minimal pain.
Speak to one of my team to get yourself booked
