Osteochondritis dissecans (OCD) is a condition where a small piece of cartilage and the underlying bone in a joint loses blood supply, causing it to loosen or detach. While it most commonly affects the knee, it can also happen in the elbow, shoulder, hip, or ankle.
Let’s take the case of a young athlete who loved soccer. They started experiencing knee pain during games and even felt a popping sensation when climbing stairs. Eventually, their knee felt unstable, like it was “giving way.” This is a classic sign of OCD in the knee, which most often affects the lower end of the femur (the thigh bone).
How Does OCD Develop?
In our young athlete’s case, OCD likely developed due to repetitive stress on the knee from frequent running and playing soccer. The condition is usually caused by reduced blood flow to the bone beneath the cartilage, which can happen due to repeated minor injuries or even genetic factors. Over time, this can damage the joint surface, leading to early arthritis if untreated.
Symptoms of OCD
Patients with OCD typically experience:
- Pain with physical activities like climbing stairs or playing sports
- Popping or locking of the joint
- Feeling that the knee is unstable or “giving way”
- Decreased range of motion
- Swelling and tenderness around the joint
Diagnosing OCD
When our young athlete visited the doctor, they underwent a thorough exam and an X-ray. While X-rays often show OCD, sometimes, as in this case, an MRI was needed to get a clearer picture of the problem.
Treating OCD
There are both non-surgical and surgical options, depending on how severe the condition is:
- Non-Surgical Treatment: For younger patients or mild cases, treatment might involve rest, stopping painful activities, and using crutches or a brace for a few months. In our athlete’s case, they had to stop playing soccer and rest the knee for several months, which can be tough but is sometimes necessary to allow the joint to heal.
- Surgery: If the cartilage piece becomes loose, surgery may be needed to remove or reattach it. This can often be done using minimally invasive “keyhole” surgery. In more severe cases, a small incision might be needed to repair the joint.
Recovery After Surgery
After surgery, many patients are eager to get back to their regular activities. In our athlete’s case, they started using a continuous passive motion (CPM) machine to keep the knee moving right after surgery. If only a loose body was removed, they were able to walk just a few days later. But if the cartilage was repaired, they were advised to avoid putting weight on the knee for up to six weeks.
With the help of physical therapy, most patients can return to their normal activities, although in some severe cases, modifying high-impact activities may be necessary to protect the joint in the long term.