Osteochondral defects

Generally pain and swelling are the main symptom, however pain related to physical activities can also be a symptom when there is a history of previous trauma. The pain is usually felt on the weight bearing side, though not always, localised to the side of the joint on which the osteochondral defect exists. It is also not uncommon to have feelings of pain related instability from the joint, despite the fact that the ligaments are all working.

Your consultant will be able to determine the degree of disruption, it can be challenging to diagnose an osteochondral defect at the time of injury, as scans may miss the damage because they are masked by the sprain or trauma that caused the injury.

The damage can range from bruising, to a crater or deep defect on the surface of the joint, lacking the underlying bone as well as cartilage. An osteochondral defect may or may not progress to osteoarthritis and a decision to have treatment will depend upon just how persistent and painful your symptoms may be.

A magnetic resonance imaging (MRI) or computed tomography (CT) scan may be required.

Your consultant will discuss treatment options to determine the best approach for you. Possible surgical treatments might include:

• arthroscopic trimming or a micro-fracture procedure, to encourage new cartilage to form
• autologous cartilage transplantation (ACI/ACT)
• mosaicplasty or OATS
• stem cell treatments

These treatments may have a role for defects that have not responded to arthroscopic debridement.