Dr. Sanjay Barik
Knee & Shoulder Surgeon
Dr. Sanjay Barik
Knee & Shoulder Surgeon
Knee Osteochondritis Dissecans (Fracture) Lesion Treatment
- Do you experience grinding, pain, loss of confidence, locking, or clicking in your knee?
- Is knee pain preventing you from enjoying daily activities, running, dancing, trekking, or playing sports?
- Is your weight increasing because you are unable to exercise due to knee osteochondritis dissecans?
We Have Solution for Your Problems
1. Percutaneous Osteochondritis Dissecans Repair
Eighty percent of Osteochondritis dissecans (OCD) cases can heal without surgery. Our objective is to heal your OCD cartilage lesion, which is crucial for preventing knee osteoarthritis. The percutaneous OCD repair procedure is designed for individuals contemplating surgery for small and acute OCD lesions.
Orthobiologic treatments leverage your body’s natural healing agents to regenerate and repair cartilage and subchondral bone by concentrating these agents precisely at the injury site. This method promotes natural and effective healing, eliminating the need for surgery.
2. OATS (osteochondral autograft transfer system) Procedure
The osteochondral autograft transfer system (OATS) is an optimal treatment for patients with osteochondritis dissecans lesions ranging from 1 to 4 cm. In the OATS procedure, a round osteochondral fragment is harvested from a non-weight-bearing area of the knee and transplanted to the lesion in the weight-bearing area.
This helps restore the damaged articular surface. For lesions smaller than 1 cm, a single autograft plug is typically used. For lesions between 2 and 4 cm, a mosaicplasty technique is employed, involving multiple smaller autograft plugs. The OATS procedure is a single-stage, minimally invasive arthroscopic surgery that allows for a quick recovery with minimal morbidity. Most patients can return to sports within three months post-surgery.
3. Autologous Chondrocyte Implantation
Autologous chondrocyte implantation presents an optimal solution for addressing larger osteochondral lesions spanning between 4 to 10 cm. This procedure entails a meticulous two-stage arthroscopic approach. Initially, during the first stage arthroscopy, healthy cartilage cells are carefully harvested from a non-weight bearing area within the knee.
These cells are then cultured in vitro over a period of 4 to 6 weeks, allowing them to regenerate. Subsequently, the second stage procedure is scheduled, involving arthroscopic debridement of the lesion, wherein damaged cartilaginous and subchondral bone tissues are meticulously excised. Following thorough removal of saline from the joint, a dry arthroscopy is performed. At this juncture, a periosteal patch or synthetic collagen graft is procured and delicately positioned over the defect, meticulously sutured along the periphery.
The cultured cells are then blended with fibrin and thrombin glue to confer adhesiveness before being applied into the defect. This amalgamation is left to set for a brief period, ensuring secure attachment to the bone. For defects exceeding a depth of 10 millimeters, bone grafting may be undertaken prior to this stage.
Bone Marrow Aspirate Concentrate (BMCA)with Fibrin Glue
This is a one-step arthroscopic procedure. First, the damaged tissue within the joint is carefully removed through arthroscopic debridement, addressing both cartilage and subchondral bone issues. Microfracture is then performed at the lesion’s base to stimulate healing. Following this, the joint is thoroughly dried through arthroscopy, ensuring optimal conditions for treatment.
Next, Bone Marrow Aspirate Concentrate (BMCA) is prepared by mixing it with fibrin and thrombin glue to create an adhesive mixture. This mixture is then applied to the lesion, allowing it to adhere to the bone surface. In cases where the defect exceeds 10 millimeters in depth, bone grafting may be performed prior to this step.
Additionally, any remaining BMCA is injected into the joint to further support the healing process. This comprehensive approach aims to promote effective tissue repair and enhance overall joint health.
Internal Fixation
High-grade osteochondral defect lesions, often accompanied by loose bodies and an articular flap, typically do not respond well to conservative treatment methods. Arthroscopic intervention is usually necessary for partially detached lesions and loose bodies containing adequate subchondral bone. During this procedure, headless Titanium variable pitch compression screws and biodegradable k-wires are utilized for reattachment.
Prior to reattaching the osteochondral fragments, meticulous preparation of the bed is essential. This involves micro-drilling and the removal of any fibrous tissue using an arthroscopic Shaver, which promotes optimal union. Notably, advancements in implant systems, such as headless compression screws and biodegradable k-wires, have obviated the need for implant removal post-surgery, as they do not provoke irritation to the tibial cartilage.
What will happen if you don't take any treatment for your OC lesion?
- Minor lesions can often be treated non-surgically through percutaneous osteochondritis dissecans repair. Without treatment, these lesions may enlarge over time, potentially necessitating surgical intervention.
- Larger costochondritis dissecans lesions can escalate, causing damage to your knee cartilage. If left untreated, this can progress to secondary knee osteoarthritis, resulting in significant knee degeneration. Eventually, the patient may necessitate knee replacement surgery.
Get back into sports faster & stronger to win the game and get medals.
Ready to get back into sports faster & stronger?
Follow These Simple Steps
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STEP 1 : WHATSAPP YOUR MRI AT 7507306684
STEP 2 : GET FREE ONLINE CONSULTATION
STEP 3 : FIX APPOINTMENT & MEET DR SANJAY BARIK
STEP 4 : CONFIRM THE DIAGNOSIS AND TREATMENT PLAN
STEP 5 : GET ACL REPAIR
STEP 6 : GET BACK TO SPORTS AND RUNNING IN 3 MONTHS
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- Rotator Cuff (Supraspinatus) Tear
Dr Sanjay Barik - Sports Injury, Arthroscopy & ACL EXPERT | Orthopedic Surgeon : Nagpur
