When present, OCD lesions usually become symptomatic during a child’s development. Osteochondritis Dissecans (OCD) is a condition that affects the articular cartilage and the subchondral bone of the knee. Osteochondritis dissecans (OCD) of the knee is a debilitating disorder primarily affecting adolescents and young adults at a rate between 15 and 30 per 100,000 , . In situ fixation of lesions can be performed using various types of metallic screws, bioabsorbable implants, or osteochondral plugs. Osteochondritis dissecans is an inflammatory condition that occurs when diseased cartilage separates from the underlying bone. Osteochondritis Dissecans (OCD) of the knee is an acquired, reversible, idiopathic condition of the subchondral bone. Theodore Ganley MD, Kevin Shea MD. If neglected, the OCD may come loose, catch in the joint, (causing pain, locking, clicking, etc.) This video demonstrates the treatment of an unstable osteochondritis dissecans (OCD) lesion of the knee. * This results in a spectrum of pathology beginning with a lesion to the bone only,… If OCD of the knee is suspected, AP, lateral, notch-view (knee in flexion) and skyline patella xrays should be ordered. However, when the OCD lesion is more mature and has separated from the rest of the bone, either with the overlying cartilage intact, partially separated or completely separated (loose body), surgery is often needed to stimulate, graft, stabilize, or remove the OCD fragment. Over time, the cartilage can fragment as well, leaving a loose piece of bone and cartilage. If a lesion is seen the contralateral knee should also be xrayed. • MADISON, WI 53718 The younger you are, the better chance you have of healing the OCD and getting back to the activities you enjoy. Mainstay of … Then we were able to place 3 BioComposite headless screws in a triangular type fashion. Osteochondritis dissecans (OCD) is 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. … It occurs when a small segment of bone begins to separate from its surrounding region due to a lack of blood supply. Key Points: • High-intensity T2-signal behind the progeny fragment of the OCD lesion is suggestive of instability. The affected area of subchondral bone and its attached articular cartilage can become loose and separate into the joint. OCD of the Knee May Require Rest or Surgery. Once the OCD is hinged open, the bed of the lesion is prepared. Multiple theories have been proposed for the cause of an OCD lesion in the knee, including trauma or repetitive microtrauma, local vascular insufficiency, and family history. Other lesions may be more appropriately treated with surgery. Following this, I was able to range the knee. Unless the lesion repairs spontaneously or it is treated, the disease process progresses. Once a patient reaches maturity, these lesions rarely heal on their own. Cartilage damage is most frequently seen between the ages of 15 and 30 or above the age of 50. The OCD lesion can remain in contact with the adjacent bone, maybe partially separated or completely separated. Surgical Treatment . In summary, OCD is an abnormality of subchondral bone that most commonly affect the medial femoral condyle of the knee. Patients may have an OLT that is present and doesn't cause pain or limitations or a lesion that becomes painful but improves. OCD lesions may occur in any joint, but are most common in the knee. Particularly in adolescent male athletes, OCD of the knee is a common source of pain, effusion, and mechanical symptoms with sporting activities. It is an important diagnosis to consider in an active pediatric/adolescent patient presenting with knee pain with or without mechanical symptoms. Cartilage can also come loose due to damage in the underlying bone, OCD, or osteonecrosis. The ankle OCD lesion is rare in the pediatric population, mainly occurring in adults with the average age being 21 years of age. Without early treatment, the lesion can become unstable or completely detached. There is an association with trauma to the ankle, particularly in lateral talar dome lesions. There is a history of trauma to the knee in 40% of patients. In these cases, no additional treatment is necessary. • Retroarticular or transarticular drilling of a non-healing, stable OCD lesion in the pediatric knee … For an elbow OCD, your child may be placed into a sling for up to 6 weeks. The most "classic" location for OCD lesions of the knee is the lateral aspect of the medial femoral condyle of the distal femur. OCD of the knee has a non-specific presentation with vague pain and swelling. In the world of childhood knee injuries and complaints, there are few mysteries that still persist. This has been shown to no longer be true. Figure 2 MRI view of an OCD lesion of the knee. The lesion, which has multiple causes, has a loss of blood supply to a small portion of the bone. If the lesion is loose and floating around in the knee, the loose piece needs to be removed via a scope. OCD is characterized by the separation of an osteochondral fragment from its surrounding bone and cartilage tissues. Theories range from abnormal vascular anatomy (leading to ischemic injury of the bone), abnormal ossification of the epiphysis, trauma, endocrine imbalances or some combination of the above. The authors’ preferred treatment algorithm for osteochondritis dissecans (OCD) of the knee is based on skeletal maturity, OCD lesion stability, and OCD lesion salvageability. This is a developmental disease that occurs in rapidly growing large breed dogs typically between 6 and 9 months of age and tends to occur more often in male dogs. promote OCD lesion healing, fixation methods, and salvage techniques. By Dr. Eric W. Edmonds . An OCD lesion is an area within the knee where the bone underneath a small area of cartilage starts to die. lesion of the knee. The cause is currently unknown but it may lead to damage to overlying cartilage, loose bodies, and joint damage. This will need surgery to repair. Various modalities and techniques exist, such as fixation, debridement, microfracture, and cartilage grafting/transplantation. Diagnosis can be made with plain radiography, and the lesion can be further characterized by MRI. The starved bone tissue starts to weaken and crumble, and, without this scaffold to support it, the cartilage can weaken as well. 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