The Knee Surgeon

Osteochondritis Dissecans

Osteochondritis dissecans (OCD) refers to a condition in which a portion of the bone and the overlying cartilage, typically in a joint, undergoes a process of degeneration and may eventually become detached. This condition most commonly affects the knee joint, especially the femoral condyles (the rounded end of the thigh bone), but it can also occur in other joints like the elbow, ankle, and shoulder. These detached fragments are sometimes called “OCD defects.”

  1. The exact cause of OCD is not always clear, but it’s believed to involve a disruption in the blood supply to the affected bone and cartilage. This disruption can lead to the degeneration and softening of the cartilage and underlying bone. Trauma, repetitive stress, genetic factors, and blood circulation issues might contribute to the development of OCD.
  2. Common symptoms of OCD include joint pain, swelling, and limited range of motion. Pain may worsen with activity and improve with rest. Some individuals may also experience joint locking or catching due to loose fragments within the joint.
    1. Diagnosis: Diagnosis typically involves a combination of physical examination, medical history review, and imaging studies like X-rays, MRI (Magnetic Resonance Imaging), and CT scans. These imaging techniques help visualize the condition of the bone and cartilage and identify any loose or detached fragments.
    2. Treatment: The treatment approach for OCD defects depends on several factors, including the size and location of the defect, the patient’s age, and the severity of symptoms. Treatment options include:
      • Non-Surgical: Rest, activity modification, and physical therapy might be recommended for mild cases. This approach is often used when the lesion is stable and not causing significant symptoms.
      • Surgical: If the defect is larger, unstable, or causing persistent symptoms, surgery may be considered. Surgical options include:
        • Debridement and Drilling: The surgeon removes any loose or damaged tissue and drills small holes into the bone to stimulate blood flow and encourage healing.
        • Osteochondral Grafting: Healthy cartilage and bone are transplanted from another area of the joint or from a donor to replace the damaged tissue.
        • Autologous Chondrocyte Implantation (ACI): This involves taking a sample of healthy cartilage from the patient, culturing and multiplying the cartilage cells in a laboratory, and then implanting them into the defect.
        • Rehabilitation: Regardless of the treatment approach, rehabilitation plays a crucial role in the recovery process. Physical therapy is often prescribed to improve joint strength, stability, and range of motion.


It’s important to note that treatment outcomes for OCD defects can vary based on individual factors. Early diagnosis and appropriate management can help prevent further joint damage and improve long-term joint function.