An osteochondral fracture is a type of fracture in which the articular cartilage at the end of a joint is torn. These fractures are most commonly seen in the knee and ankle joints, as these joints are highly stressed and weight-bearing, which can make them vulnerable to damage. Depending on the severity of the fracture, there are various treatment options ranging from fairly conservative treatments to surgery. It is important to treat an osteochondral fracture because such fractures can lead to the development of osteoarthritis later in life.
When an osteochondral fracture occurs, it is common for there to be fragments of bone and cartilage within the joint. Sometimes they remain attached to the joint, in which case they are known as stable, while in other cases, they are unstable, floating within the joint. These fragments are a cause for concern because they can grind up the joint, causing further damage as well as making the joint quite painful.
An X-ray can be used to identify an osteochondral fracture, and sometimes other medical imaging studies can be used to get a more complete picture of what is happening inside the joint. These studies are also used to recommend treatment. In a minor osteochondral fracture, treatment may be as simple as resting and shaping to allow the joint to heal on its own. Younger patients often do very well with this type of treatment because their growing bodies allow the joint to heal quickly and catch up with the rest of the body.
If fragments are present, it may be necessary to enter the joint to remove the fragments and stabilize the joint. Large missing pieces can be replaced with a graft so that the joint remains relatively stable after the osteochondral fracture heals. The surgery is often performed arthroscopically, inserting cameras and surgical instruments through small incisions around the joint to access the area of interest. After surgery, a cast may be used to keep the joint immobile in the early stages of healing.
Healing time for an osteochondral fracture varies, depending on the severity of the fracture. One of the problems with these fractures is that they often go unrecognized in the early stages. The patient may think the joint is stiff and sore, not realizing that ongoing damage is taking place. By the time the fracture is identified, the situation may be much more serious and more extensive treatment may be required.