Joint, Ligament and Muscle Disorders

Osteochondritis Dissecans (OCD)

Anatomy

Joints are formed where the ends of the bones meet. There are many joints in the body, including the ankle, shoulder and knee. Healthy joints move easily because a smooth, slippery tissue called articular cartilage covers and protects the ends of the bones, where they touch.

Description

Osteochondritis dissecans (OCD) is a joint condition that occurs when a small segment of bone separates from its surrounding region due to a lack of blood supply. As a result, the bone segment and cartilage covering it begin to crack and loosen. OCD develops most often in children and adolescents, frequently in the knee, at the end of the femur (thighbone).

Symptoms

Initial symptoms are pain and swelling of a joint, most commonly brought on by sports or other physical activities. In advanced cases, OCD may cause joint catching or locking.

Nonsurgical Treatment

Rest and avoiding sports or other vigorous activities often provides relief from pain and swelling. If symptoms do not subside after a reasonable amount of time, your doctor may recommend the use of crutches. Splinting or casting of the affected leg or other joint may be prescribed for a short period of time.

Surgery

Your physician may recommend surgery if nonsurgical treatment fails to provide relief of symptoms. Surgery may also be necessary if the lesion is separated or detached from the surrounding bone and cartilage and is moving around within the joint; or if the lesion is larger than 1 centimeter in diameter, especially in older teens.

Depending upon the individual case, surgical techniques for treating OCD vary and may include:

• Drilling into the lesion to create pathways for new blood vessels to nourish the affected area and encourage healing of the surrounding bone.
• Holding the lesion in place with internal fixation such as pins and screws.
• Replacing the damaged area with a new piece of bone and cartilage (a graft), which can help regenerate healthy bone and cartilage.

With any surgery there are some risks, and these vary from person to person. Complications are typically minor, treatable and unlikely to affect your final outcome. Your orthopaedic surgeon will speak to you prior to surgery to explain any potential risks and complications that may be associated with your procedure.

Outcome

A gradual return to sports may be possible after about 4 to 5 months.

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