or MRI will be used follow the OCD and see if your OCD is healing. Most of the available literature on treatment has been retrospective in nature or small case series. It is an important diagnosis to consider in an active pediatric/adolescent patient presenting with knee pain with or without mechanical symptoms. Maruyama M, et al. Accessed Aug. 8, 2018. Your doctor will also check other structures around the joint, such as the ligaments. We retrospectively reviewed 11 children with OCD of the knee treated with a fresh stored osteochondral allograft between 2004 and 2009 (six males and five females). If it is thought the fragment can heal, your doctor will most likely try to repair the OCD lesion, usually by using screws or pins to hold the fragment in place. A joint surface damaged by OCD doesn’t heal naturally. Patella OCD • Rare, est. Theodore Ganley MD, Kevin Shea MDWhen OCD affects the knee, the most common location is within the lateral aspect of the medial femoral condyle. Drilling into the lesion to create pathways for new blood vessels to nourish the affected area. Sign up and learn how to better take care of your body. We have many case loads that reflect common scenarios patients face. OCD occurs most often in children and adolescents. Osteochondritis dissecans (OCD) of the knee is a condition that has continued to perplex the orthopaedic community in its origin, despite clear advances in identification and treatment. May 2011 vol. Theodore Ganley MD, Kevin Shea MD. Jonathan Cluett, MD, is a board-certified orthopedic surgeon with subspecialty training in sports medicine and arthroscopic surgery. treatment.5 AOCD lesions have a greater propensity for instabil-ity, and they typically follow a clinical course that is progressive and unremitting.30 The highest rates of OCD appear among patients between 10 and 15 years old, ranking among the most common causes of knee pain and dysfunction in teenagers.5,30,35 The prevalence of Mayo Clinic, Rochester, Minn. Aug. 8, 2018. Nonsurgical treatments help in about half the cases of JOCD. ... Fifty-two studies described the results of 65 treatment groups of treatment strategies for OCD of the talus. Abbreviation: OCD, osteochondritis dissecans. Hergenroeder AC, et al. (Left) An OCD lesion at the end of the femur. Osteochondritis dissecans (OCD) is a bone and cartilage injury that affects the knee, ankle and elbow. In some cases, you or your doctor will be able to feel a loose fragment inside your joint. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. Younger patients with minimal discomfort can be treated with rest and a period of non-weight bearing to allow the bony fragment to heal into its anatomic location. Share on Pinterest OCD can cause pain and discomfort in the knee and other joints. Most OCD lesions occur in the knee, though they can also form in the elbow and sometimes in other joints such as the ankle. Are your joints swollen? Click below and just hit send! OCD of the Knee. Mayo Clinic is a not-for-profit organization. Younger patients with minimal discomfort can be treated with rest and a period of non-weight bearing to allow the bony fragment to heal into its anatomic location. We also have provided a list of resources to find more information. If so, when? Drilling, open or arthroscopic fixation, fragment excision, microfractures, osteochondral grafting (with autograft or allograft) and autologous chondrocyte implantation (ACI) have … The condition can be mild, moderate, or severe. This softening is caused by an interruption in … Reproduced with permission from Crawford DC, Safran MR: Osteochondritis dissecans of the knee. Have you injured that joint? Osteochondritis Dissecans (OCD) is a disease in which localized osteocartilaginous separation at the level of the subchondral bone causes damage to the protective articular cartilage cover, subsequently producing pain and swelling. Which of the following is the most appropriate initial treatment? OCD is most common in the knee joint, but it can happen in other joints such as the elbow and ankle. What are the principles of surgical treatment of OCD of knee? In children whose bones are still growing, the bone defect may heal with a period of rest and protection. Indications for surgical treatment are based on … Curr Rev Musculoskelet Med. If the loosened piece of cartilage and bone stays in place, you may have few or no symptoms. It is treated by orthopaedic physicians at CHOP. When an OCD fragment is likely to heal, non-surgical treatment can be effective.. Patella OCD • Rare, est. https://orthoinfo.aaos.org/en/staying-healthy/a-guide-to-safety-for-young-athletes. Bilateral osteochondritis dissecans of the femoral condyles in both knees: a report of two sibling cases. One randomized clinical trial was identified. https://www.uptodate.com/contents/search. The authors conclude by saying that treatment for OCD of the knee is most successful when the condition is caught early and treated before long-lasting damage can be done. Curr Rev Musculoskelet Med. Both male and female athletes can develop OCD, most commonly between the ages of 10 and 20 years old. This guide will help you understand 1. where in the knee the condition develops 2. how doctors diagnose the problem 3. what treatment options are available Open Reduction, Bone Grafting, and Internal Fixation of Osteochondritis Dissecans Lesion of the Knee. OCD is more common in males. Generally, OCD seems to affect males more commonly than females (between 2:1 and 3:1). If left untreated, OCD can cause severe arthritis as well as a host of other physical problems. The literature on conservative treatments for knee OCD is scarce. What treatments or self-care measures have you tried? The average age of the children at the time of their allograft surgery was 15.2 years (range, 13–20 years). For this reason, the treatment and prognosis of OCD and JOCD can be very different. Advertising revenue supports our not-for-profit mission. The following are a few examples of the many surgeries that are currently available to treat OCD. Radiographs of the right knee demonstrate open growth plates and a well circumscribed 1x1cm area of sclerotic subchondral bone with a radiolucent halo separating this area from his femoral epiphysis. 2016;29(07):533-538. doi:10.1055/s-0036-1586723, Sanders TL, Pareek A, Johnson NR, et al. https://rarediseases.info.nih.gov/diseases/12703/osteochondritis-dissecans. Osteochondritis Dissecans (OCD) of the knee is an acquired, reversible, idiopathic condition of the subchondral bone. The condition can be mild, moderate, or severe. When the cartilage is damaged, a number of problems can occur. A recent paper that my colleagues and I published in The Journal of Bone and Joint Surgery in 2012 reported the results of five different techniques to treat OCD. The American Academy of Orthopaedic Surgeons (AAOS) approved this clinical practice guideline on December 4, 2010. Has anything helped? 19 no. Diagnosis and Treatment of Osteochondritis Dissecans. Epub 2009 Oct 27. Osteochondritis dissecans (OCD or OD) is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone. No single treatment works for everybody. Your doctor will also ask you to move your joint in different directions to see whether the joint can move smoothly through its normal range of motion. The condition can be mild, moderate, or severe. 2013 Jun. 2017;5(7):2325967117704644. doi:10.1177/2325967117704644, Herring MJ, Knudsen ML, Macalena JA. Important variables affect the choice of treatment. However, as females and younger children participate in sports there has been an increased prevalence among girls and a younger mean age of OCD onset. Do they lock or give out on you? In a normal knee joint, a layer of cartilage that is several millimeters thick evenly coats the bone surfaces. OCD is a type of osteochondrosis in which a lesion has formed within the cartilage layer itself, giving rise to secondary inflammation. Distribution . Management of osteochondritis dissecans (OCD). Make a donation. OCD of the knee has a non-specific presentation with vague pain and swelling. The goal of surgical treatment is to end up with a stable cartilage surface of the joint. About 85% of knee lesions are on the medial femoral condyle. Surgical Treatment . Osteochondritis dissecans. In children with open growth plates, there is a higher chance for spontaneous healing with activity modification or immobilization than in adults. Due to a lack of evidence on its early diagnosis, optimal treatment, and long-term course of healing, JOCD presents a unique challenge for the health care team. 2019;9(3):e23. https://orthoinfo.aaos.org/en/diseases--conditions/osteochondritis-dissecans. Osteochondritis dissecans, often called OCD for short, is a condition that causes loosening of cartilage and its supporting bone. © 1998-2020 Mayo Foundation for Medical Education and Research (MFMER). J Am Acad Orthop Surg. Thank you, {{form.email}}, for signing up. Orthop J Sports Med. The elbow and ankle are the next most common joints affected. Osteochondritis dissecans is a disease that affects the bone and cartilage, most often in the knee in children and adolescents, causing pain, swelling and locking of the joint. The OCD lesion ('lesion' is the cartilage and any bone attached to the cartilage fragment) can loosen and break off from the joint surface. Does Joint Cracking and Snapping Cause Arthritis? Category 1 (ie, girls younger than 11 y, boys younger than 13 y): These patients usually do well with nonoperative treatment. Summary: OCD of the knee requires a timely diagnosis to maximize opportunity to perform a reparative procedure. Why or why not? Accessed Aug. 7, 2018. American Academy of Orthopaedic Surgeons. All rights reserved. Signs and symptoms. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic. The Journal of Knee Surgery. Successful results have been reported in … A person who experiences the symptoms of OCD in a joint should seek medical advice. In the world of childhood knee injuries and complaints, there are few mysteries that still persist. Replacing the damaged area with a new piece of bone and cartilage (called a graft). 6(2):102-14. . Anatomic locations of juvenile osteochondritis dissecans and osteochondritis dissecans in the knee. The lack of normal blood flow damages the bone that supports the layer of cartilage. p.82-87. Osteochondritis dissecans is often caused by sports that put repeated stress on the joint. COVID-19 Update . If the likelihood of healing is low, the loose cartilage will be removed from the knee, and treatment will be focused on stimulating new cartilage growth in the void on the joint surface. 7,9,23,78 Regardless, treatment should seek to prevent early-onset osteoarthritis, which is associated with unhealed lesions and may show favorable … Treatment of Osteochondritis Dissecans Knee Dr. LaPrade offers specialized treatment for osteochondritis dissecans of the knee. OCD usually causes pain during and after sports. (OBQ07.91) An 11-year-old boy complains of 4 weeks of medial knee pain that began while playing tennis. A radiograph and MRI is shown in Figures A and B. The surgeon makes the treatment decision with the patient's interests in mind but by taking into consideration the size and depth of the lesion. The leading thought as to why knee OCD happens relates to the thin layer of growth cartilage that caps the end of long bones, such as the femur or thigh bone. Treatment of OCD lesions is dictated by the extent of the lesion and the age of the patient at the time of diagnosis. The review was conducted between May 2009 and March 2010. A single copy of these materials may be reprinted for noncommercial personal use only. By Dr. Eric W. Edmonds . Most OCD lesions occur in the knee, though they can also form in the elbow and sometimes in other joints such as the ankle. The joint knee requires a timely diagnosis to be increasing among active children of treatment. Much more ocd knee treatment to heal itself Yoon HS the elbow and ankle having joint..., Macalena JA which a fragment of cartilage floating around the joint, although it can happen other... Amling M, Bohndorf K, Meenen NM normal blood flow to the Terms and Conditions Privacy... Generally, OCD seems to affect males more commonly than females ( 2:1! Diagnosis to consider in an active pediatric/adolescent patient presenting with knee pain with or mechanical... 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