Osteochondral & Chondral Injuries

Question 1

Pathogenesis of ostechondral/chondral injuries?

Answer 1

Impaction/shear of articular surface

-Direct blow

Question 2

What could a defect in the surface of an osteochondral/chondral joint fill with?

Answer 2

Fibrocartilage (scar type hyaline tissue)

Question 3

Signs/symptoms of osteochondral/chondral injury?

Answer 3

Ongoing pain and effusion after knee injury warrants further investigation

Question 4

Investigation of chondral/osteochondral injury?

Answer 4

X-ray
MRI
Arthroscopy

Question 5

Treatment of acute osteochondral injuries?

Answer 5

• Large osteochondral fragments with a substantial portion of bone: should be fixed with pins
• Non-weight bearing area/little bone attached: remove arthroscopically
• Mosaicplasty: osteochondral plugs from non-weight bearing areas & plug into defect culturing chondrocytes from a sample of hyaline cartilage on biological membrane, suturing into the defect

Question 6

If the defect has bare bone at its base what may treat it?

Answer 6

Drilled holes made to induce bleeding (Microfracture): this promotes fibrocartilage formation from stem cells