York, ME (207) 363 3490 | Portsmouth, NH (603) 431 1121

20Hip Care
10Hip-Conditions and Injuries
Cartilage Injury
Femoroacetabular Impingement (FAI)
Gluteal Tears
Hamstring Tears
Hip Instability
Deep Gluteal Space Syndrome
Labral Tears
Psoas Impingement (Internal Snapping Hip)
Trochanteric Bursitis
10Hip-Treatment and Surgeries
Gluteal Repair
Labral Debridement
Labral Reconstruction
Labral Repair
Psoas Release
Trochanteric Bursa Debridement
33Knee Care
13Knee Conditions and Injuries
ACL Tear
Cartilage Injury
Discoid Meniscus
Lateral Meniscus Tear
LCL Injury
MCL Injury
Medial Meniscus Tear
Osteochondritis Dessicans
Patellar Instability
Patellofemoral Chondromalacia
Posterolateral Corner Injury
Trochlear Dysplasia
20Knee Treatment and Surgeries
Anterior Cruciate Ligament (ACL) Reconstruction
Cartilage Restoration Surgery – Autologous Chondrocyte Implantation (ACI-Carticel)
Cartilage Restoration Surgery – Donor Graft
Collagen Meniscal Implant (CMI)
Lateral Collateral Ligament (LCL) Reconstruction
Medial Collateral Ligament (MCL) Reconstruction
Meniscus Repair
Meniscus Root Repair
Meniscal Transplant
Medial Patellofemoral Ligament (MPFL) Reconstruction
Osteochondral Allograft Transfer
Osteochondral Autograft Transfer (OATS)
Partial Knee Replacement (MAKO)
Partial Meniscectomy
Posterior Cruciate Ligament (PCL) Reconstruction
Posterolateral Corner (PLC) Surgery
Tibial Tubercle Osteotomy
Total Knee Replacement (MAKO)
20Shoulder Care
10Shoulder-Conditions and Injuries
AC Joint Injuries
Biceps Tendon Injuries
Calcific Tendinitis
Clavicle Fractures
Frozen Shoulder
Labral and SLAP Tears
Rotator Cuff Injuries
Shoulder Dislocation/Instability
Subacromial Impingement/Busitis
10Shoulder-Treatment and Surgeries
A-C Joint Stabilization
Biceps Tenodesis
Clavicle Fracture Fixation
Pectoralis Major Repair
Rotator Cuff Repair
Shoulder Instability Surgery – Bankart Repair
Shoulder Instability Surgery – Latarjet Procedure
Subacromial Decompression and Acromioplasty
Superior Capsular Reconstruction
Total Shoulder Replacement


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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