Osteochondritis Dissecans (OCD)

During the early childhood years, an injury to a particular joint, may affect the growth factors of the joint and later act as a causative factor in developing Osteochondritis Dissecans. In the older individual the most likely cause would be a sudden extreme trauma that will place an abnormal stretch on a ligament beyond its normal range of motion, and an even more likely scenario would be that the stretch has caused minute or complete tears within the ligament. These cracks or tears will remain due to the fact that cartilage has limited healing properties. There can also be cracks on the head of the bone in the affected joint. When this occurs, chips may flake off within the joint.

The results of the ligament being minutely torn or having a complete tear and the cracks within the bonehead and possible flaking within the joint, will cause inflammation and severely affect the joints range of motion. Athletes are ideal candidates to develop Osteochondritis Dissecans in a joint that is most used in that particular sport. A prime example would be baseball pitchers who constantly place extreme stress on the shoulder and elbow. Another example would be a tennis player who not only places extreme stress on the shoulder and elbow, but the knees will be impacted as well. Any individual having OCD of a joint will have a sound in that joint known as crepitus. As in many diseases OCD occurs in a progressive manor and the results would be diagnosed as stage I, II, III and IV.

X-rays and MRI Scans can usually diagnose Osteochondritis Dissecans (OCD). The x-rays and MRI Scans will also determine if there are any malignant lesions present. In Osteochondritis Dissecans the knee is the joint most affected in many individuals, and the condition is so severe because in OCD the ligaments and bone are deprived of their blood supply, causing the death (necrosis) of the bone and is the usual reason for the need of knee replacement surgery. If the cartilage is not too badly torn or desiccated, it can possibly be repaired with arthroscopic surgery, avoiding a full knee replacement procedure. After the arthroscopic surgery, the period of rehabilitation will be shorter, than if there was a full replacement. The patient will be the prime factor in the rehabilitation following arthroscopic surgery. Mainly the rehabilitation will consist of using RICE, not the food but the acronym as follows:

R: Rest. Stop using the injured area for at least 48 hours.

I: Reduce inflammation with use of cold compresses. Use ice packs for 20 minutes and repeat for pproximately 8 times daily.

C: Compression to prevent undue movement. Use an ace bandage and wrap firmly, but not so tightly as to cut off circulation.

E: Elevation to help circulatory drainage. Elevate the injured area so that it is elevated above heart level, using one or two pillows if necessary.

The use of RICE as physical therapy will continue until the patient regains full range of motion and is able to use the leg without pain. They will then be able to return to their normal daily routine and activities.