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Osteochondritis Dissecans of the Knee

Osteochondritis dissecans (OCD) is a joint condition that causes knee pain and limited ability to extend and bend the knee. While the exact cause is unknown, the condition may occur due to a loss of blood flow to the area underneath the cartilage in the knee, causing part of the bone to die. Usually seen in children and adolescents active in sports, the condition results in fragments of bone loosening and sometimes detaching from the bone.

Osteochondritis Dissecans of the Knee Hero Image 2

Osteochondritis dissecans (OCD) is a joint condition that causes knee pain and limited ability to extend and bend the knee. While the exact cause is unknown, the condition may occur due to a loss of blood flow to the area underneath the cartilage in the knee, causing part of the bone to die. Usually seen in children and adolescents active in sports, the condition results in fragments of bone loosening and sometimes detaching from the bone.

Osteochondritis dissecans has four different stages of severity:

• Stage I: The cartilage begins to thicken, but both the cartilage and bone are considered stable.
• Stage II: The cartilage begins to crack, but it is still considered stable.
• Stage III: The cartilage has cracked completely and the underlying bone has begun to crack. When this happens, the structure is considered unstable.
• Stage IV: The cartilage and/or bone has detached from its original position. It is considered unstable.

What causes Osteochondritis Dissecans of the Knee?

Doctors do not fully understand what causes osteochondritis dissecans, but it is most likely due to restricted blood flow to the cartilage of the knee. There may also be a genetic predisposition.

OCD typically occurs in young athletes, particularly those who play sports that involve running, jumping, or other high-impact activity. An acute injury or repeated trauma may play a role, but this condition sometimes occurs without any injury. Sports associated with OCD include:

• Running
• Basketball
• Soccer
• Gymnastics

Symptoms

If you or your child have OCD of the knee, symptoms may include:

• Pain, sometimes brought on by sports activity
• Mild swelling
• Clicking and locking of the knee
• Decreased range of motion

When to see a doctor

If you or your child experience these symptoms and they don’t go away, you should see your doctor. After conducting a physical examination, your doctor may prescribe an x-ray or magnetic resonance imaging (MRI) test. These imaging tests provide a detailed picture of the bone and cartilage that makes up your knee. They can help your doctor determine the size of the affected area and the stage of the disease.

Non-operative treatment

In children and adolescents, particularly those with a lot more growing ahead of them, OCD typically resolves on its own as the affected bone heals in place. Rest and limited vigorous activity can help to address pain and swelling. Your doctor may recommend crutches or a splint if symptoms don’t resolve with rest and limited activity. Nonsteroidal anti-inflammatory medications (NSAIDs) may also be prescribed to relieve symptoms.

Surgical Treatment

In older children and young adults, there is a greater chance the affected bone may separate from the larger bone and cartilage. In these cases, surgery is usually recommended. Surgery can help save the affected bone by securing it to the knee, allowing it to heal in place. Bone that has become separated may need to be removed.

Recovery

Athletes not requiring surgery usually recover within two to four months. A full return to play is expected after symptoms subside.

After surgery, patients can expect to use crutches for six weeks. Physical therapy may be needed for several months to regain strength. The time necessary for full recovery depends on the type of surgery performed and can vary from three to six months.

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