An osteochondral fracture is a type of fracture in which the articular cartilage at the end of a joint becomes torn. These fractures are most commonly seen in the knee and ankle joints, as these joints take a lot of strain and bear a lot of weight, which can make them vulnerable to damage. Depending on the severity of the fracture, there are a number of treatment options ranging from fairly conservative treatments to surgery. It is important to get this type of fracture treated 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 inside the joint. Sometimes they remain attached to the joint, in which case they are known as stable, while in other instances, they are unstable, floating around inside the joint. These fragments are a cause of concern because they can grind at the joint, causing additional damage in addition to making the joint rather painful.
An x-ray can be used to identify an osteochondral fracture, and sometimes other medical imaging studies may be used to get a more complete picture of what is going on inside the joint. These studies are also used to recommend a treatment. In a mild osteochondral fracture, the treatment may be as simple as rest and casting to allow the joint time to heal on its own. Younger patients often heal very well with this type of treatment because their growing bodies allow the joint to quickly heal and catch up with the rest of the body.
If fragments are present, it may be necessary to go into the joint to remove the fragments and stabilize the joint. Large missing pieces may be replaced with grafting so that the joint will remain relatively stable after the fracture heals. Surgery is often performed arthroscopically, by inserting cameras and surgical instruments through small incisions around the joint to access the area of concern. After surgery, casting may be used to keep the joint still in the early stages of healing.
Healing time from 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 that the joint is just stiff and sore, not realizing that ongoing damage is occurring. By the time the fracture is identified, the situation may be much more serious, and more extensive treatment may be required.