Osteochondritis Dessicans (OCD)


Osteochondritis dissecans is a fracturing or cracking of the articular cartilage, the material lining the end of a bone, and the subchondral bone underneath it. It results in significant pain and swelling in the affected joint, depriving it of its normal range of function.

Osteochondritis dissecans can affect any joint, but it’s most common in the knees, ankles, and elbows. As the condition progresses, it gradually restricts circulation to the subchondral bone, causing lesions to form. As a result, the exposed cartilage and the surrounding bone are subject to increased friction, speeding the degeneration of the joint.


Osteochondritis dissecans can be diagnosed with a physical examination. After evaluating the condition’s effects on the joint’s range of motion and locating the specific source of pain, your orthopedic specialist will take an X-ray to evaluate any skeletal defects that might contribute to the condition, as well as an MRI to determine the extent of the damage to the cartilage.

Treatment for osteochondritis dissecans largely depends on the severity of the condition. If it hasn’t resulted in the formation of loose bodies, it can be treated by immobilizing the affected joint until any lesions in the subchondral bone have healed (and refraining from any activities that might damage the joint in the future). In most cases, however, osteochondritis dissecans needs to be treated surgically, since the articular cartilage cannot heal by itself.


Surgery for osteochondritis dissecans is usually performed arthroscopically, but the specifics of the procedure depend on the extent of the damage. If the lesions are relatively minor, your surgeon will drill into the subchondral bone to encourage the formation of of a cartilage-like scab, which will protect the bone from additional damage. In other cases, the lesions can be grafted back on to the bone with screws or sutures, though more severe lesions will need to be debrided before the repair can be completed.


Recovery timelines for osteochondritis dissecans depend on which joint has been affected and the extent of the damage.


Patients with osteochondritis dissecans in the knee will need to walk on crutches for six to eight weeks after surgery to ensure that the lesions heal properly. After an additional two to four months of physical therapy, most patients will be able to walk without restrictions.


Patients with osteochondritis dissecans in the elbow will need to wear an arm brace for several weeks after surgery to support the joint as it heals. Once the brace is removed, patients can begin a physical therapy program designed to restore function to the joint. Most patients can expect to completely recover after several months of rehabilitation.


Patients with osteochondritis dissecans in the ankle will not be able to place weight on the joint for four to six weeks after surgery, but they can begin basic motion exercises within several days. Complete recovery should come after several months of rest and physical therapy.



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