Osteochondritis Dissecans

Osteochondritis dissecans (OCD) is a condition that affects the joints, most commonly the knee, but it can also occur in other joints such as the elbow, ankle, or hip. It involves the separation of a piece of cartilage and underlying bone from the joint surface.

The exact cause of OCD is not fully understood, but it is believed to involve a combination of genetic predisposition, repetitive trauma, and impaired blood supply to the affected area. It often affects adolescents and young adults involved in sports activities.

The symptoms of OCD can vary but typically include joint pain, swelling, and stiffness. Some individuals may also experience a catching or locking sensation within the joint. The severity of symptoms can range from mild discomfort to significant limitations in joint function.

Treatment options for osteochondritis dissecans depend on various factors, such as the size and location of the lesion, the age of the patient, and the presence of symptoms. The primary goals of treatment are to relieve pain, promote healing, and restore joint function. Treatment approaches may include:

1. Conservative management: In cases where the lesion is small and stable, and symptoms are mild, non-surgical management may be attempted. This can involve rest, activity modification, physical therapy, and anti-inflammatory medications to reduce pain and inflammation. Regular monitoring and follow-up imaging are necessary to assess the progression of the condition.

2. Surgical interventions: Surgical treatment may be considered for larger lesions, unstable fragments, or persistent symptoms that do not respond to conservative measures. The surgical options include:

  – Arthroscopic debridement: In this minimally invasive procedure, loose fragments of cartilage or bone are removed, and the remaining area is smoothed to promote healing.

    – Microfracture: This procedure involves creating small holes in the exposed bone to stimulate the formation of new cartilage.

    – Osteochondral autograft or allograft transplantation: Healthy cartilage and bone from another part of the joint (autograft) or a donor (allograft) are transplanted to replace the damaged area.  

– Internal fixation: For cases where the lesion is unstable, surgical techniques such as screw fixation or pins may be used to secure the fragment in place while it heals.

The choice of surgical procedure depends on several factors, including the size, location, and stability of the lesion, as well as the surgeon’s expertise and preference.

Postoperative rehabilitation typically involves a period of protected weight-bearing, physical therapy, and a gradual return to activities to promote healing and optimize joint function.

It’s important for individuals with osteochondritis dissecans to work closely with their healthcare provider or orthopedic specialist to determine the most appropriate treatment approach based on their specific condition and individual needs. At Total Orthopedics and Sports Medicine we have pediatric orthopedics and sports medicine surgeons who provide the full array of specialized services that may be necessary to treat this condition.