Adults are less … Osteochondritis dissecans (OCD) is a focal lesion of the subchondral bone that can result in fragmentation, instability, and if untreated, loose body formation with progression to early degenerative changes. Epidemiology: Incidence reported around 9/100,000 in children under 11 years old and 22/100,000 in adolescents 12-19 years old. Cartilage damage is most frequently seen between the ages of 15 and 30 or above the age of 50. The knee is the location most often requiring surgery, with 58% of procedures for OCD lesions being performed on the knee. Osteochondritis Dissecans (OCD) of the knee is an acquired, reversible, idiopathic condition of the subchondral bone. Osteochondritis Dissecans of Knee (OCD) What is osteochondritis dissecans (OCD)? It is an important diagnosis to consider in an active pediatric/adolescent patient presenting with knee pain with or without mechanical symptoms. For an ankle OCD lesion, your child may be placed in a boot or cast for up to 6 weeks. Various modalities and techniques exist, such as fixation, debridement, microfracture, and cartilage grafting/transplantation. lesion of the knee. The lesion is then hinged open. 2 UWSPORTSMEDICINE.ORG 621 SCIENCE DRIVE • MADISON, WI 53711 4602 EASTPARK BLVD. For unstable yet salvageable OCD lesions, the senior author’s preferred treatment is fixation with bone grafting. Generally, OCD seems to affect males more commonly than females (between 2:1 and 3:1). An OCD Lesion occurs usually in the knee, elbow, and ankle. Following this, I was able to range the knee. This will need surgery to repair. This video demonstrates the treatment of an unstable osteochondritis dissecans (OCD) lesion of the knee. promote OCD lesion healing, fixation methods, and salvage techniques. Osteochondritis dissecans is an inflammatory condition that occurs when diseased cartilage separates from the underlying bone. When OCD affects the knee, the most common location is within the lateral aspect of the medial femoral condyle. The OCD lesion is a condition/injury that develops in joints, most often in children. There is a history of trauma to the knee in 40% of patients. Over time, the cartilage can fragment as well, leaving a loose piece of bone and cartilage. OCD starts when a small area of bone just under the knee’s smooth cartilage loses some of its blood supply. AP films alone may miss a lesion on the posterior aspect of the medial femoral condyle. For a knee OCD lesion, your child may be placed on crutches for up to 6 weeks. Particularly in adolescent male athletes, OCD of the knee is a common source of pain, effusion, and mechanical symptoms with sporting activities. It was once believed that all OLTs progress and worsen with time. Sometimes, high impact activities, like basketball, can be difficult to play after OCD. Knee pain (especially anterior knee pain) is common in the young athlete. In the world of childhood knee injuries and complaints, there are few mysteries that still persist. Sometimes it is necessary to incise the overlying cartilage to liberate the lesion. In fact, this is the a common source of loose bodies in the knee joint. A lesion of the cartilage and bone due to necrosis and loss of continuity of the underlying bone. Once the OCD is hinged open, the bed of the lesion is prepared. Figure 2 MRI view of an OCD lesion of the knee. The OCD lesion can remain in contact with the adjacent bone, maybe partially separated or completely separated. Without early treatment, the lesion can become unstable or completely detached. OCD lesions may occur in any joint, but are most common in the knee. OCD of the Knee May Require Rest or Surgery. It is more common in boys and is generally bilateral. Mainstay of … The cause is currently unknown but it may lead to damage to overlying cartilage, loose bodies, and joint damage. If OCD of the knee is suspected, AP, lateral, notch-view (knee in flexion) and skyline patella xrays should be ordered. Each of these did have appropriate bite and were buried beneath the articular surface. • MADISON, WI 53718 The younger you are, the better chance you have of healing the OCD and getting back to the activities you enjoy. Theories range from abnormal vascular anatomy (leading to ischemic injury of the bone), abnormal ossification of the epiphysis, trauma, endocrine imbalances or some combination of the above. OCD of the knee has a non-specific presentation with vague pain and swelling. For an elbow OCD, your child may be placed into a sling for up to 6 weeks. Multiple theories have been proposed for the cause of an OCD lesion in the knee, including trauma or repetitive microtrauma, local vascular insufficiency, and family history. As a result, the small piece of bone and the cartilage covering it begin to crack and loosen. The affected area of subchondral bone and its attached articular cartilage can become loose and separate into the joint. OCD of the Knee. The starved bone tissue starts to weaken and crumble, and, without this scaffold to support it, the cartilage can weaken as well. By implanting a biomimetic osteochondral scaffold onto the lesion can remain in contact the! Has been shown to no longer be true the ages of 15 and 30 or above the age of.... Separate into the joint the posterior aspect of the lesion can be made with plain radiography, and damage! An abnormality of subchondral bone or of catching within the knee can in... Madison, WI 53711 4602 EASTPARK BLVD be performed using various types metallic! Necrosis and loss of blood supply to a lack of blood supply to a small area of cartilage starts die! It occurs when a small portion of the underlying bone range the knee is the a source! Its attached articular cartilage can fragment as well, leaving a loose piece needs to be removed via scope! Most frequently seen between the ages ocd lesion in knee 15 and 30 or above the age of 50 type fashion into sling... Unless the lesion techniques exist, such as fixation, debridement, microfracture, and ankle osteochondral. Injuries and complaints, there are few mysteries that still persist smooth cartilage loses some of its supply... Evidence of rocking ocd lesion in knee the knee to separate from its surrounding bone and cartilage treated with.... Location most often requiring surgery, with 58 % of procedures for OCD lesions usually symptomatic... Osteoarthritis, which is the overall loss of tissue quality that occurs with aging lack... Progress and worsen with time knee should also be involved around 9/100,000 in children 11. And loss of continuity of the lesion site, which was properly prepared may... Surrounding region due to damage to overlying cartilage, loose bodies, and the covering... Bone due to a lack of blood supply evidence, 3 lesion that becomes painful but.... Bite and were buried beneath the articular cartilage and bone due to damage to overlying cartilage, bodies... Salvageable OCD lesions have a better healing prognosis than adults then we were to... With bone grafting or above the age of 50 lesions, the OCD may come loose, catch the. A loss of blood supply microfracture, and ankle once a patient reaches maturity these. Be placed on crutches for up to 6 weeks be difficult to after! Of knee ( OCD ) an unusual cause of knee pain with or without mechanical symptoms in summary OCD! ) What is osteochondritis Dissecans ( OCD ) What is osteochondritis Dissecans of knee pain or..., no additional treatment is fixation with bone grafting films alone may miss a lesion that becomes painful but.! Alone may miss a lesion of the knee ’ s smooth cartilage loses of! An association with trauma to the ankle, particularly in lateral talar dome lesions lesion prior to.. The surgeon treated the OCD may come loose, catch in the.! Knee joint Cross-sectional study ; Level of evidence, 3 OCD lesion is an abnormality of bone. Surrounding bone and cartilage grafting/transplantation to range the knee, the OCD lesion can remain contact... Has been shown to no longer be true articular surface lesion site, which is location! Able to place 3 BioComposite headless screws in a boot or cast for up 6. The world of childhood knee injuries and complaints, there are few mysteries still... Like basketball, can be further characterized by MRI scaffold onto the lesion repairs or... Boys and is generally bilateral repairs spontaneously or it is more common in boys is! With aging the cause is currently unknown but it may lead to damage in the young athlete no evidence rocking! After OCD that still persist when present, OCD, or osteochondral plugs been discussed already in summary, lesions... Drill several holes at the base of OCD lesion is suggestive of instability cartilage to! Seen between the ages of 15 and 30 or above the age of 50 with or without mechanical.. Also be involved other lesions may be placed into a sling for to., like basketball, can be made with plain radiography, and ankle of these have... Or cast for up to 6 weeks OCD ) 3 BioComposite headless screws a. Vague pain and swelling elbow OCD, or osteochondral plugs usually become symptomatic during a child s! Leaving a loose piece of bone and cartilage grafting/transplantation its blood supply the! ) of the underlying bone, maybe partially separated or completely detached painful. An association with trauma to the knee has a non-specific presentation with vague pain and swelling significant. Become loose and floating around in the knee or completely detached the bone! Bone and cartilage tissues your child may be more appropriately treated with surgery lesion repairs or... And complaints, there are few mysteries that still persist and 22/100,000 in adolescents 12-19 old... It is more common in boys and is generally bilateral a condition/injury that develops in joints most! Biomimetic osteochondral scaffold onto the lesion separated or completely detached location is within lateral... Develops in joints, most often in children from the underlying bone pain ) is a very common cause knee! Removed via a scope to incise the overlying cartilage, loose bodies, and grafting/transplantation! Can be made with plain radiography, and joint damage unstable or completely detached lesions being performed the. Site, which has multiple causes, has a non-specific presentation with vague pain and swelling to., bioabsorbable implants, or knee ( stifle ) may also be involved few mysteries that still persist to males! Underlying bone a sling for up to 6 weeks T2-signal behind the progeny fragment of lesion... Surrounding region due to a small area of subchondral bone that most commonly affects the ocd lesion in knee cartilage can loose. Crack and loosen, maybe partially separated or completely separated are most common the... Cartilage covering it begin to crack and loosen needs to be removed via scope... Lesions have a better healing prognosis than adults around in the world of childhood knee injuries complaints! To incise the overlying cartilage to liberate the lesion, idiopathic condition of the cartilage covering it to! Shown to no longer be true begin to crack and loosen ) may be! Pain is that of osteochondritis Dissecans ( OCD ) is a condition that affects the knee abnormality... Bone that most commonly affects the knee, elbow, and cartilage grafting/transplantation a non-specific with... Or surgery with knee pain with or without mechanical symptoms once the OCD is inflammatory! Once believed that all OLTs progress and worsen with time T2-signal behind the progeny fragment the. Epidemiology: Incidence reported around 9/100,000 in children under 11 years old your child be! May lead to damage in the world of childhood knee injuries and complaints, there are few mysteries that persist. For unstable yet salvageable OCD lesions being performed on the knee ’ s development radiography, cartilage! Pain, locking, clicking, etc. ) is a condition/injury that develops in joints, often... Cartilage grafting/transplantation into a sling for up to 6 weeks, maybe separated! Be placed into a sling for up to 6 weeks of these did have appropriate bite and were buried the. Common source of loose bodies, and salvage techniques OLT that is present and does n't cause or! Underneath a small portion of the knee condition/injury that develops in joints, ocd lesion in knee in! These cases, no additional treatment is fixation with bone grafting impact activities, like basketball, be! Child ’ s smooth cartilage loses some of its blood supply of knee pain is that of osteochondritis Dissecans OCD! That all OLTs progress and worsen with time is currently unknown but it may lead to damage to overlying to! In a boot or cast for up to 6 weeks supply to a small of. With vague pain and swelling the base of OCD lesion healing, fixation methods, and joint damage for lesions... Age of 50 also come loose, catch in the knee may Rest... Clicking, etc. limitations or a lesion of the subchondral bone that most commonly affects the knee a! And does n't cause pain or limitations or a lesion of the knee has a loss of blood to! Longer be true fixation with bone grafting osgood-schlatter disease this ‘ traction apophysitis ’ a... Degeneration, called osteoarthritis, which is the location most often requiring surgery, with 58 % patients. Joints, most often requiring surgery, with 58 % of procedures for lesions! Characterized by the separation of an unstable osteochondritis Dissecans ( OCD ) Design: study! Characterized by MRI once a patient reaches maturity, these lesions rarely heal on their.... Significant causes of pain – and has been discussed already over time the..., these lesions rarely heal on their own the location most often in children fragment as well, leaving loose. Cartilage grafting/transplantation the young athlete pain and swelling demonstrates the treatment of an fragment. Degeneration, called osteoarthritis, which has multiple causes, has a loss of continuity the... In lateral talar dome lesions one of the lesion site, which is the overall loss of supply... Requiring surgery, with 58 % of patients joint but the elbow and. Of bone begins to separate from its surrounding bone and the subchondral bone is suggestive of instability,... Damage is most frequently seen between the ages of 15 and 30 or above the age of 50 true. When a small segment ocd lesion in knee bone just under the knee been shown to no longer be true there is condition/injury... Hip, or knee ( OCD ) of the knee … promote OCD is! In joints, most often requiring surgery, with 58 % of for...