Exercises are chosen to help improve knee motion and to get the muscles toned and active again. This is one cause of degenerative arthritis and osteoarthritis. A joint surface damaged by OCD doesn’t heal naturally. It is based on a systematic review of published studies on the diagnosis and treatment of osteochondritis dissecans (OCD) of the knee. Osteochondritis dissecans (OCD) is a condition that develops in joints, most often in children and adolescents. If the arthroscope can be used, the procedure requires smaller incisions than for an open surgery. Posted December 15, 2008. At first, emphasis is placed on exercising the knee in positions and movements that don’t strain the healing part of the cartilage. When you are well under way, regular visits to your therapist’s office will end. A lesion of the cartilage and bone due to necrosis and loss of continuity of the underlying bone. This video demonstrates the treatment of an unstable osteochondritis dissecans (OCD) lesion of the knee. Even with surgery, OCD usually leads to future joint problems, including degenerative arthritis and osteoarthritis. A heavy schedule of training and competing can stress the femur in a way that leads to JOCD. I have just had surgery to treat OCD (osteochondritis dissecans) of my left knee. Once your treating physician confirms that an OCD is present on X-ray, and that there is no evidence to suggest a second diagnosis as the source of pain, treatment should begin with further diagnostic evaluation and rest. 1 Although not necessarily an inflammatory process, the name has remained throughout the literature. Physical therapists will also work with patients to make sure they are only putting a safe amount of weight on the affected leg. However, even though it was first described in 1888 by German surgeon Franz König, osteochondritis dissecans (OCD) of the knee remains an enigma. A new technology called autologous chondrocyte implantation is currently being developed. Without blood flow, the area of damaged bone actually dies. This gives the area time to heal. The term OCD was first used by Koenig to explain the late formation of loose bodies in the knee joint. OCD mostly affects the femoral condyles of the knee. The American Academy of Orthopaedic Surgeons (AAOS) approved this clinical practice guideline on December 4, 2010. Nonsurgical treatments help in about half the cases of JOCD. Eric W. Edmonds, M.D., is a pediatric and adolescent orthopedic sports medicine specialist at Rady Children’s Hospital-San Diego and an assistant professor at UC San Diego. Although many surgeons feel that surgery is the more conservative treatment with less risk and improved outcomes, it is not universally accepted as the initial treatment. Usually, the donor site for this procedure is on the joint surface of the injured knee. The area of bone just under the cartilage surface is injured, leading to damage to the blood vessels of the bone. OCD can occur any time from early adulthood on, but most patients are adults under age 50. In this case, bone material is transplanted into the hole left in the bone. knee (most common) ... World Series of Surgery OCD Lesion: Diagnosis, Evaluation and Management - Geoffrey Van Thiel, MD (CSMS #45, 2018) Knee & Sports - Osteochondritis Dissecans A … Mild OCD: A piece of bone has begun to separate from the joint, but this piece is still firmly held in place by a covering of cartilage (dense elastic tissue that helps cushion the joint). If you have surgery, Dr. Kiritsis may have you use a continuous passive motion (CPM) machine after surgery to help the knee begin to move and to alleviate joint stiffness. i just had surgery on my knee for ocd mine is 2.9cm by 1.8cm the doctor made the same cuts to my knee 2 small ones and one big one half way down my knee its like 2inches long. As the program evolves, more challenging exercises are chosen to safely advance the knee’s strength and function. It also means that the lesions cause pain and problems when walking and putting weight on the knee. The goals of treatment for Osteochondritis Dissecans are to reduce pain, restore the continuity of the articular surface, and decrease the likelihood of future degenerative joint disease (osteoarthritis). It occurs when a small segment of bone begins to crack and separate from its surrounding region due to a lack of blood supply. During that time, it is crucial to stop doing everything that causes pain to the knee. See osteochondritis dissecans article for a general discussion. OCD lesions may occur in any joint, but are most common in the knee. As the condition becomes worse, the area of bone that is affected may collapse, causing a notch to form in the smooth joint surface. Osteochondritis dissecans (OCD) most commonly affects the knee. OCD and JOCD cause the same kind of damage to the knee, but they are separate diseases. Children with the better prognosis can be treated conservatively at first. The MRI machine uses magnetic waves rather than X-rays to show the soft tissues of the body. When, for example, repetitive trauma results in a blood supply injury or blunt injury to this growth cartilage, then the bone can either fail to develop from the original cartilage, or the maturing bone dies, softens and collapses. In osteochondritis dissecans, fragments of cartilage or bone become loose within a joint, leading to pain and inflammation.These fragments are sometimes referred to as joint mice. This means that the problem area is under constant stress and doesn’t get time to heal. It is more common for the lesions to occur on the medial femoral condyle, because the inside of the knee bears more weight. My doctor preformed the OATS (osteoarticular transfer system) procedure on July 1st. 3. With the exception of arthroscopic removal of a loose body, patients are instructed to avoid putting too much weight on their foot when standing or walking for up to six weeks. Surgery may include removing or fixing loose pieces, or stimulating the OCD to heal by drilling it with a small wire. It is a process that evolves over a few years. What is osteochondritis dissecans (OCD)? Even with surgery, OCD usually leads to future joint problems, including  osteoarthritis. The articular cartilage surface may be intact or may be breached allowing communication of the joint fluid with the bone. Eventually, there is too much pain to put full weight on that knee. Some patients who are too near the end of bone growth may not benefit with nonsurgical treatment. Osteochondritis Dissecans (OCD) of the Knee Dr. David Geier is an orthopedic surgeon and sports medicine specialist in Charleston, South Carolina. The cause is currently unknown but it may lead to damage to overlying cartilage, loose bodies, and joint damage. As a result, within joints such as the shoulder, elbow, knee, and hock (ankle), a flap of cartilage can develop causing lameness. Download a Guide to our Knee-Saving Procedures. To know more please visit http://www.hanyelrashidymd.com/ Open surgery is needed when Dr. Kiritsis can’t get a picture of the entire lesion, when it is unclear how the fragment would best fit into the bone, or when it would be too difficult to replace the fragment using the arthroscope. The goal is to help the lesions heal before growth stops in the thighbone. Dr. Kiritsis will have you work with a physical therapist for four to six to twelve weeks. You will be asked about your current symptoms and about other knee or joint problems you have had in the past. When the lesion has become so bad that it detaches totally or partially from the bone, nonsurgical treatment will not work. Weight bearing is usually restricted for up to four months after transplant procedures. For unstable yet salvageable OCD lesions, the senior author's preferred treatment is fixation with bone grafting. Because OCD leads to damage to the surface of the joint, the condition can lead to problems with bone degeneration and osteoarthritis. This means stopping exercise and sports. When this happens, JOCD develops into OCD. The cartilage over this dead section of bone (the lesion) may become damaged. Share on Pinterest OCD can cause pain and discomfort in the knee and other joints. You may be asked to walk, move, or stretch your knee. Surgery is usually the only effective treatment for OCD. 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