From the Guidelines
Osteochondritis dissecans (OCD) is a joint condition in which a piece of cartilage, along with a thin layer of the bone beneath it, comes loose from the end of a bone due to inadequate blood supply, leading to pain and swelling 1.
Key Characteristics
- The condition is often associated with inadequate blood supply to the affected area, which can lead to the formation of a loose piece of cartilage and bone 1.
- Pain and swelling are common symptoms of OCD, and can be severe in some cases 1.
- The condition can be diagnosed using radiographs and MRI, which can help to identify the location and severity of the lesion 1.
Treatment Options
- Conservative management is often the first line of treatment, and may include rest, physical therapy, and medications such as acetaminophen 650-1000mg every 4-6 hours or ibuprofen 400-800mg every 6-8 hours for pain management 1.
- In severe cases, surgical intervention may be necessary to repair or remove the damaged cartilage and bone 1.
Important Considerations
- The condition can increase the risk of developing severe osteoarthritis at a young age, particularly if left untreated or if treatment is delayed 1.
- Informed consent is essential for patients who are considering surgery, and should include a discussion of the potential risks and benefits of the procedure 1.
From the Research
Definition of Osteochondritis
- Osteochondritis Dissecans (OCD) is a condition that affects subchondral bone and secondarily its overlying cartilage, mostly found in the knee 2.
- It is characterized by 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 3.
- OCD can cause pain, effusion, and loose body formation, and its treatment depends on the size of the lesion, cartilage stability, and the physeal status 4.
Causes and Symptoms
- The aetiology of OCD remains unknown 2.
- Symptoms of OCD include pain, effusion, and mechanical symptoms, which arise depending on the stage of the disease 2, 5.
- Early disease without separation of the lesion results in pain, while separation of the lesion leads to mechanical symptoms and swelling, and in advanced cases, the formation of loose bodies 2.
Treatment Options
- Nonoperative treatment is recommended for stable lesions, while unstable and symptomatic lesions require operative management 5.
- Surgical treatment options include removal of loose body, microfractures, osteochondral autograft and allograft transplantation, autologous chondrocyte implantation (ACI), arthroscopic removal of the loose body, and internal fixation of the fragment using k-wire or screw 5, 3.
- Other treatment options include subchondral bone implantation of peripheral blood stem cells (PBSCs) 6 and autologous iliac bone graft with hyaluronic acid scaffold 4.