If the lesion becomes totally or partially detached, surgery is needed to remove the loose body or to fix it in place. Osteochondritis dissecans, often called OCD for short, is a condition that causes loosening of cartilage and its supporting bone. Introduction. Download a Guide to our Knee-Saving Procedures. When these problems develop, your Dr. Kiritsis may suggest surgery. Sometimes JOCD is not treated or does not heal completely. The leading thought as to why knee OCD happens relates to the thin layer of growth cartilage that caps the end of long bones, such as the femur or thigh bone. The lesions usually occur in the part of the joint that holds most of the body’s weight. The American Academy of Orthopaedic Surgeons (AAOS) approved this clinical practice guideline on December 4, 2010. I plan to go out of town to see a specialist and so I can get surgery on it. This requires a period of activity modification and even bracing or casting during this rest period. The goals of treatment for Osteochondritis Dissecans are to reduce pain, restore the continuity of the articular surface, and decrease the likelihood of future degenerative joint disease (osteoarthritis). I was recently diagnosed with OCD of the left knee. OCD and JOCD cause the same symptoms. Osteochondritis Dissecans of Knee (OCD) What is osteochondritis dissecans (OCD)? This can cause a snapping or catching feeling as the knee joint moves across the notched area. In some cases, other muscle or bone problems can cause extra stress and contribute to JOCD. The cartilage over this dead section of bone (the lesion) may become damaged. Signs and symptoms. Related Document: A Patient’s Guide to Articular Cartilage Problems of the Knee. It may require using crutches or wearing a brace for a couple of months when symptoms are present. A lesion of the cartilage and bone due to necrosis and loss of continuity of the underlying bone. This means that the problem area is under constant stress and doesn’t get time to heal. If not, Dr. Kiritsis may suggest an MRI. The next test is a magnetic resonance imaging (MRI). The elbow and ankle are the next most common joints affected. Many doctors think that JOCD is caused by repeated stress to the bone. Even with surgery, OCD usually leads to future joint problems, including degenerative arthritis and osteoarthritis. In the child who is still growing, the problem is much more likely to heal itself. OCD of the knee is thought to be bilateral, or in both knees, about 1 out of 4 times. Open surgery usually requires larger incisions than arthroscopic surgery to allow the Dr. Kiritsis to see into the knee and perform the operation. This area of dead bone can be seen on an X-ray and is sometimes referred to as the osteochondritis lesion. 1 Although not necessarily an inflammatory process, the name has remained throughout the literature. Even with surgery, OCD usually leads to future joint problems, including osteoarthritis. A decision to progress each patient to the next phase should be … OCD is a radiologic diagnosis. Although many surgeons feel that surgery is the more conservative treatment with less risk and improved outcomes, it is not universally accepted as the initial treatment. These symptoms are fairly common in athletes. Mild OCD: A piece of bone has begun to separate from the joint, but this piece is still firmly held in place by a covering of cartilage (dense elastic tissue that helps cushion the joint). For unstable yet salvageable OCD lesions, the senior author's preferred treatment is fixation with bone grafting. came across ur ocd knee post and am kinda looking for some questions if u don't mind. The leading thought as to why knee OCD happens relates to the thin layer of growth cartilage that caps the end of long bones, such as the femur or thigh bone. Look for information on OCD, different OCD, cases & research on OCD. Once the piece has broken off, surgery is almost always necessary. OCD mostly affects the femoral condyles of the knee. Medical Website Design by PBHS © 2020 • Non-Discrimination Notice, Orthopedic Surgeon Paul Kiritsis Treats Injuries and Disorders of the Shoulder and Knee in Midlothian VA, ACL Reconstruction with Hamstring Autograft, ACL Reconstruction with Patellar Tendon Autograft, Glucosamine and Chondroitin Sulfate for Osteoarthritis of the Knee, Viscosupplementation for Osteoarthritis of the Knee, Post-Operative Instructions: Shoulder Surgery, Post-Operative Instructions: Knee Surgery, A Patient’s Guide to Osteoarthritis of the Knee, A Patient’s Guide to Articular Cartilage Problems of the Knee. The damaged fragment often doesn’t fit perfectly into the bone anymore. What is osteochondritis dissecans (OCD)? As the program evolves, more challenging exercises are chosen to safely advance the knee’s strength and function. 3. The MRI machine uses magnetic waves rather than X-rays to show the soft tissues of the body. This means stopping exercise and sports. You may be advised to avoid heavy sport or work activities for up to eight weeks. In order to do that, the bone must be healthy and have enough blood supply. The guideline provides practice recommendations and highlights gaps in the literature and areas that require future research. However, there is no known link between OCD of the knee and OCD of other joints. It involves using cartilage cells (chondrocytes) to help regenerate articular cartilage. When the lesion has become so bad that it detaches totally or partially from the bone, nonsurgical treatment will not work. Dr. Kiritsis has seen excellent results with this surgery and has seen many athletes return to their pre-injury level of activity. Learn more about different pediatric orthopaedic treatments, procedures and surgery. Because OCD leads to damage to the surface of the joint, the condition can lead to problems with bone degeneration and osteoarthritis. Moving the knee becomes painful, and it may be swollen and sore to the touch. Dr. Kiritsis may also use an arthroscope, a tiny camera inserted into the knee to look at your knee before doing surgery to fix the problem. This sometimes proves difficult. As a result, within joints such as the shoulder, elbow, knee, and hock (ankle), a flap of cartilage can develop causing lameness. If the loose bone fragment is in a weight-bearing area of your bone, Dr. Kiritsis may try to reattach it if possible. In the world of childhood knee injuries and complaints, there are few mysteries that still persist. © 2020 Rady Children's Hospital–San Diego, OCD of the Knee May Require Rest or Surgery, COVID-19 Updates: Latest Information for Parents. OCD is most common in the knee joint, but it can happen in other joints such as the elbow and ankle. In some cases the dead area of bone may actually become detached from the rest of the femur, forming what is called a loose body. For this reason, the treatment and prognosis of OCD and JOCD can be very different. My doctor preformed the OATS (osteoarticular transfer system) procedure on July 1st. Even with surgery, OCD usually leads to future joint problems, including osteoarthritis. If there is no improvement in the X-rays or the symptoms, then surgery may be beneficial. This loose body may float around inside of the knee joint. During that time, it is crucial to stop doing everything that causes pain to the knee. Related Document: A Patient’s Guide to Knee Anatomy. With the exception of arthroscopic removal of a loose body, patients are instructed to avoid putting too much weight on their foot when standing or walking for up to six weeks. And the bone around the fragment has often changed in ways that mean Dr. Kiritsis will need to rebuild it. They may require a walker or pair of crutches for up to six weeks to avoid putting too much pressure on the joint when they are up and about. Share on Pinterest OCD can cause pain and discomfort in the knee and other joints. This video demonstrates the treatment of an unstable osteochondritis dissecans (OCD) lesion of the knee. A heavy schedule of training and competing can stress the femur in a way that leads to JOCD. Nonsurgical treatments help in about half the cases of JOCD. This may result in separation and instability of a segment of cartilage and free movement of these osteochondral fragments within the joint space.That process can lead to pain, loose body formation and joint effusion. I have just had surgery to treat OCD (osteochondritis dissecans) of my left knee. Midlothian Orthopedic Surgeon, Dr. Paul Kiritsis, is dedicated to providing you with a pleasant visit. Most young people with JOCD have been involved in competitive sports since they were very young. Range-of-motion and stretching exercises are used to improve knee motion. Osteochondritis dissecans (OCD) is a disease that originates in the subchondral bone that affects the articular cartilage. Most areas of scientific inquiry concerning the knee revolve around the major ligaments and our knowledge of these injuries is so far advanced that often the remaining questions are minor fine-tuning. In this case, bone material is transplanted into the hole left in the bone. Call Paul Kiritsis, MD Phone Number 804-379-2414 with any questions or to make an appointment. The therapist’s goal is to help you keep your pain under control, ensure safe weight bearing, and improve your strength and range of motion. You will also be shown strengthening exercises for the hip and knee to help steady the knee and give it additional protection from shock and stress. The aforementioned 2012 study in The Journal of Bone and Joint Surgery assessed the clinical outcomes of these five different surgical techniques in patients affected by OCD of the knee… When a person gets OCD later in life, it is probably a brand new problem. Dr. Kiritsis will order an X-ray of your knee. If the OCD does not heal or if it is unstable, surgery will be recommended. There are a number of treatment options. Dr. Kiritsis may want to reevaluate the knee and may suggest additional tests if your symptoms change. Osteochondritis dissecans (OCD) is a problem that affects the knee, mostly at the end of the big bone of the thigh (the femur). These tests may help determine the extent of damage from OCD and JOCD, and they also help rule out other problems. Children as young as nine or ten can develop this condition. OCD can occur any time from early adulthood on, but most patients are adults under age 50. Each knee has two femoral condyles, referred to as the medial femoral condyle (on the inside of the knee) and the lateral femoral condyle (on the outside). Exercises are chosen to help improve knee motion and to get the muscles toned and active again. Children with the better prognosis can be treated conservatively at first. Could you please tell me how long the recovery time would be for the surgery because … The summation of these MRI findings may be predictive of OCD progression or ability to heal without surgery. The cause is currently unknown but it may lead to damage to overlying cartilage, loose bodies, and joint damage. Some patients who are too near the end of bone growth may not benefit with nonsurgical treatment. Treatments & Surgery. The younger the patient and the smaller more stable appearing the OCD, the better the outcome and prognosis to heal. The authors' preferred treatment algorithm for osteochondritis dissecans (OCD) of the knee is based on skeletal maturity, OCD lesion stability, and OCD lesion salvageability. Some patients may be encouraged to modify their activity choices, especially if an allograft was used. Stable lesions will be left alone to heal, although unstable lesions may be surgically fixed back in place. The knee may catch or lock when it is moved if the loose body gets in the way. Any loose bodies and bo… Patients are strongly advised to follow the recommendations about how much weight is safe. Your therapist may issue shock-absorbing shoe insoles to reduce impact and protect your knee joint. It also means that the lesions cause pain and problems when walking and putting weight on the knee. This gives the area time to heal. Next most common joints affected surrounding region due to necrosis and loss of continuity of the joint fluid the. 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