Osteochondritis Dissecans

Osteochondritis dissecans (OCD) is a condition in the joints where the articular cartilage along with a small segment of the bone beneath it begins to loosen. This rare disorder occurs most frequently affects the knee, but may also affect the ankle, elbow and other joints.

What causes Osteochodritis Dissecans?

The causes of OCD are not known, but the reduction of blood flow may be due to repetitive trauma or stresses to the bone over time. In many cases of OCD in children, especially when they are still growing, the affected bone and cartilage will heal on their own. However, in some cases there are may be fragmentation of both cartilage and bone that breaks off into the joint, which can lead to pain and long term damage such as arthritis. These cases require surgical consultation with an orthopedic specialist.

What are the symptoms?

The symptoms may include:

  • Pain
  • Swelling
  • Joint catching or locking

What tests do I need?

X-rays – Will be needed for an initial OCD diagnosis, and to evaluate the size and location of the OCD lesion.

MRI – Will reveal the extent to which the overlying cartilage is affected.

What are the treatment options?

Observational – OCD lesions in growing adolescents will in most cases heal on their own. Rest and avoiding vigorous physical exercises will help reduce the pain and swelling.

Non-Surgical – If symptoms persist, your physician may recommend the use of crutches, or splinting of casting of the affected joint area for a short period of time. In most cases, symptoms improve in a couple of months.

Surgical – Treatment may be recommended by your physician if:

  • Nonsurgical methods are ineffective
  • The lesion is very large (greater than 1 cm in diameter)
  • The fragmented lesion has detached and is moving around in the joint;
  • Your child’s knee bones are done growing. There are different surgical methods unique for each case.
  • Fixing the lesion in place with pins and screws
  • Drilling into lesion to create a pathway for new blood vessels to nourish the damaged bone
  • Using bone and cartilage grafts to replace the lesion and regenerate healthy bone