Osteochondritis Dissecans
Osteochondritis dissecans (OCD) is a painful condition that can sideline young athletes for months if left untreated. This condition tends to affect active adolescents and young adults.
The Basics of OCD
OCD occurs when the hyaline cartilage and subchondral bone that make up a joint become separated. The knee is most commonly affected, especially the area where the thighbone and shinbone meet.
The exact cause of OCD is unclear. Blood supply disruption to the cartilage and bone is often involved, leading to weakening and eventual separation of a piece of cartilage and bone.
Skeletal immaturity, high levels of physical activity, growth spurts and injuries during adolescence and young adulthood all make these age groups more susceptible to developing osteochondritis dissecans. The disorder is less common in middle-aged adults and the elderly because their joints have had time to fully develop and stabilize.
Symptoms of OCD
The main symptoms of osteochondritis dissecans (OCD) are:
Pain - This is typically the most prominent symptom. The pain is often worsened by activity or force on the joint. It can range from a dull ache to sharp pain.
Swelling - Increased fluid buildup in the joint, causing it to appear puffy or swollen. This occurs as the body's immune response to joint damage and inflammation.
Stiffness - The joint may feel stiff, especially in the morning or after periods of inactivity. This is due to inflammation and decreased range of motion.
Decreased range of motion - The affected joint may have a limited ability to flex, extend or rotate. This is caused by the fragment separation and associated joint damage.
Locking - The joint may suddenly "lock up" and become difficult to move. This happens when the loose fragment displaces and blocks normal joint motion.
Popping or clicking - A sudden popping or clicking sensation may occur in the joint. This indicates movement of the loose OCD fragment within the joint.
Grinding - An audible or tactile grinding sensation may be felt when moving the joint. This results from abnormal contact between the loose fragment and surrounding joint surface.
Other potential symptoms of OCD include muscle weakness, difficulty performing daily activities, and swelling or redness in severe cases due to joint infection.
The most important thing is to be aware of any new joint pain, swelling, locking, popping or decreased range of motion - especially if there was an injury prior to the symptoms developing. These could indicate osteochondritis dissecans and should be evaluated promptly by an orthopedic surgeon.
Treatment Options
The recommended initial treatment includes rest, physical therapy and anti-inflammatory medications to reduce symptoms. Immobilizing the joint for a period of time can help with healing.
For more severe OCD with large loose cartilage and/or bone fragments, surgery may be needed. The goal of surgery is to reattach or remove the fragment and restore the normal cartilage surface. New techniques use screws or drill holes to stabilize the loose fragment and promote healing.
Getting You Back in the Game
With appropriate treatment, many young patients with OCD are able to return to sports and daily activities. The body's natural healing abilities at a younger age often lead to the best outcomes.
If you suspect your teen has OCD, don't delay - schedule an evaluation with an experienced orthopaedic surgeon like Dr Sean for an accurate diagnosis and the best treatment plan for getting you or your child back in the game.