osteochondrale

Osteochondrale is an anatomical term describing tissue relating to both bone and cartilage. In clinical practice it commonly refers to pathology that affects the osteochondral unit, the interface between articular cartilage and the subchondral bone.

The osteochondral unit comprises cartilage, the calcified cartilage zone, and the subjacent subchondral bone. Damage can involve the cartilage surface and underlying bone, resulting in an osteochondral lesion or defect. Lesions may arise after acute trauma, repetitive microtrauma, ischemia, or inflammatory conditions; in younger patients, osteochondritis dissecans is a related disorder affecting subchondral bone and overlying cartilage.

Common sites for osteochondral pathology include the knee (femoral condyles and trochlea), ankle (talus), and elbow (capitellum). Patients typically present with joint pain, swelling, mechanical symptoms such as catching or locking, and reduced range of motion.

Diagnosis combines clinical assessment with imaging. Plain radiographs can detect bony changes, but magnetic resonance imaging (MRI) is preferred for assessing cartilage status, bone marrow edema, and lesion size. Computed tomography (CT) provides detailed evaluation of subchondral bone contours, and arthroscopy offers direct visualization and potential concurrent treatment.

Management depends on lesion size, depth, location, patient age, and joint stability. Nonoperative care includes activity modification, bracing, and structured rehabilitation, addressing malalignment or instability if present. Operative options for larger or symptomatic lesions include microfracture, drilling, osteochondral autograft transfer (OATS), autologous chondrocyte implantation (ACI), and osteochondral allograft transplantation, as well as fixation of dislodged osteochondral fragments in appropriate cases. Postoperative rehabilitation is tailored to the procedure.

Prognosis varies with lesion characteristics and treatment timing; smaller lesions in younger patients tend to have better outcomes, while larger defects and associated joint malalignment pose higher risks of persistent symptoms and early osteoarthritis.