Prognosis
The prognosis depends on several factors. A number of studies point out the importance of early detection and diagnosis.
In 50% of cases, juvenile osteochondritis dissecans lesions of the knee will heal within 10 to 18 months in the compliant patient.[2]
A poor prognostic indicator in children is the presence of a perilesional sclerotic rim in the osteochondritis dissecans lesions of the knee. Lesions with sclerosis show worse evolution, and treatment with perforations is still essential for enhancement of healing. Children under 12 years of age show less perilesional sclerosis and more tendencies to spontaneously heal than those more than 15 years of age.[53]
In the skeletally mature, osteochondritis dissecans carries a worse prognosis and surgical intervention is usually necessary. Stable lesions can have a favourable outcome if the lesion is recognised early and the offending activity is avoided. Unstable lesions can result in joint incongruity and intra-articular loose bodies leading to irreversible premature degenerative changes.
Athletes who do best after surgery tend to be younger, have a shorter preoperative duration of symptoms, have no previous surgical interventions, participate in more rigorous rehabilitation, and have smaller cartilage defects.[54]
Unstable and large lesions may result in joint destruction, stiffness, and pain. Newer salvage procedures to attempt articular cartilage reconstruction or regeneration may improve outcomes in the near future, but more research is necessary.
Use of this content is subject to our disclaimer