OSTEOCHONDRITIS DESSICANS (OCD)
Osteochondritis dessicans (OCD) is a disorder that involves articular cartilage and can affect any joint in the body; however it occurs most commonly in the knee. An OCD lesion is an area in the knee in which cartilage and the bone underneath the cartilage becomes loose and unstable. The leading theory is that poor blood flow leads to the development of OCD lesions. The condition usually affects adolescents and young men under the age of 25. Most individuals with this condition do not have any symptoms. Over time, an OCD lesion may naturally heal on its own, most commonly in children and adolescents who are still growing. However, in some individuals, the OCD fragment becomes unstable and can cause significant symptoms in the knee.
- Swelling in the knee
- Pain at rest and with activity
- Catching in the knee
- Joint locking (unable to fully bend or straighten the knee)
Diagnosis And Treatment
Dr. Welch considers each patient’s symptoms, as well as a detailed physical examination, x-rays, and sometimes and MRI of the knee to make the diagnosis. X-rays and an MRI are very important because the images help reveal the exact location and size of the lesion. An MRI also gives Dr. Welch a 3D view of the knee, and an MRI may reveal if an OCD lesion is unstable.
In those patients with a “stable” OCD lesion, particularly in young patients with open growth plates, Dr. Welch usually recommends non-surgical management. Non-surgical management includes rest (no sports), crutch use, range of motion and strengthening exercises, and anti-inflammatory medication.
In those patients who have symptoms and are found to have an unstable OCD lesion on MRI, Dr. Welch may recommend surgical intervention. There are several options for surgery that Dr. Welch considers for each individual, including fixation with screw(s), removal of the loose fragment, or cartilage restoration. Dr. Welch considers several variables, including patient age, and size and location of the OCD lesion, before making his specific procedure recommendation.
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